How do you choose a child’s therapist?

[sangtarah]

Where do you start? What questions do you ask? 

I called a recommended place that seemed like it’d be a great fit, but they aren’t taking our insurance right now (and actively avoiding it in the future). So I’m left with a list of insurance in-network, and kinda lost on how to wade through them all. 

ETA: for anxiety

Edited January 16, 2019 by sangtarah
overwhelmed

[sangtarah]

7 minutes ago, Arctic Mama said:

What kind of therapist?

 

I have different criteria for the different disciplines.

 

Yup. That would help. 🙄

For anxiety. 

I edited to add.

[fairfarmhand]

Ask your pediatrician.

the guidance counselor at a near by school should have a list too, or at least know someone who does. 

 

[AmandaVT]

DS saw a therapist for anxiety for a year and a half. She was amazing! I would suggest starting with Psychology Today. Read the profiles of the therapists in your area and network. I can't tell how old your kiddo is, but DS was 9 when he started and almost 11 when we were discharged. The one we settled on did a lot of play therapy. We did a check in with me there in the beginning of each appointment and then DS stayed in with her and I waited. 

We did not use the therapist that insisted that she didn't need to meet our son at all and only needed to meet with DH and I. That was odd and not appropriate for our situation. 

Our therapist had a background in working with kids with trauma, which DS didn't have, but it gave her a great perspective on things. She also has 2 kids of her own and was about my age, which made for really easy relationship building. 

I would recommend trying to chat with them on the phone for a few minutes if you can to get a feel for their personality. 

[scholastica]

Do you trust your pediatrician and do hey know your child well enough to make a recommendation? I would start there.

[gardenmom5]

for starters - you want someone whose focus is on CHILD anxiety.   have you ruled out any medical cause?

then you want to know what therapies they use, and which ones are appropriate for childhood anxiety. 

are there any pediatric mental health clinics near you?  has the child had a complete workup by a specialist?  I would start there.

I had my insurance company rec a therapist whose specialty is eating disorders, another marriage counseling (for a child with asd, add, and anxiety) . . . . we won't go into how many of their "suggestions" i trashed before even talking to them.

[Ravin]

Since we were on medicaid when DD's problems started, we didn't get much say in who her therapist was. We were referred to a mental health provider that works with medicaid in our state, and assigned to someone.

In our case, she was good, and we were fortunate that I got employer insurance in time to follow her when she left the agency she'd worked for and went private. DD trusts her, has a good rapport with her, and she has been very helpful.

[sangtarah]

4 hours ago, fairfarmhand said:

Ask your pediatrician.

the guidance counselor at a near by school should have a list too, or at least know someone who does. 

 

 

3 hours ago, scholastica said:

Do you trust your pediatrician and do hey know your child well enough to make a recommendation? I would start there.

 

The pediatrician didn’t have a good recommendation. I asked several months ago, so I could ask again, but I’m not hopeful on that front.

[sangtarah]

4 hours ago, AmandaVT said:

DS saw a therapist for anxiety for a year and a half. She was amazing! I would suggest starting with Psychology Today. Read the profiles of the therapists in your area and network. I can't tell how old your kiddo is, but DS was 9 when he started and almost 11 when we were discharged. The one we settled on did a lot of play therapy. We did a check in with me there in the beginning of each appointment and then DS stayed in with her and I waited. 

We did not use the therapist that insisted that she didn't need to meet our son at all and only needed to meet with DH and I. That was odd and not appropriate for our situation. 

Our therapist had a background in working with kids with trauma, which DS didn't have, but it gave her a great perspective on things. She also has 2 kids of her own and was about my age, which made for really easy relationship building. 

I would recommend trying to chat with them on the phone for a few minutes if you can to get a feel for their personality. 

 

I’ll check Psychology Today out. Thanks.

3 hours ago, gardenmom5 said:

for starters - you want someone whose focus is on CHILD anxiety.   have you ruled out any medical cause?

then you want to know what therapies they use, and which ones are appropriate for childhood anxiety. 

are there any pediatric mental health clinics near you?  has the child had a complete workup by a specialist?  I would start there.

I had my insurance company rec a therapist whose specialty is eating disorders, another marriage counseling (for a child with asd, add, and anxiety) . . . . we won't go into how many of their "suggestions" i trashed before even talking to them.

 

She has Hashi’s hypothyroidism, so we are making sure her meds are okay this week. I found a place that seemed great, the therapist had a daughter with Hashi’s, too, but they won’t take our insurance. So still looking. I haven’t found any clinics focusing only on pediatrics.

We have never done a mental health work up. Does a counselor do that? I noticed some of them have an initial screening, is that similar? 

[Mimm]

In an ideal world, you would interview several therapists who specialized in helping children with your child's problems, discuss a plan for helping your child, and pick the one who you liked the best. 

In real life, your choice is determined by:

Cost. Who will take your insurance, who has a sliding scale, will your insurance cover out of network, etc.

Availability. I have had bored schedulers tell me it would be a year before my suffering child could see anyone. The apathy you meet with in the mental health world is just... lovely.

Those two things tend to be a determining factor much more than who would be the right fit for your child. My advice is that if you find someone you think might be right for them and they are scheduling months or even a year out, go ahead and get on the schedule. You never know what life will be like then. Maybe you'll want the appointment and maybe you won't.

See if your insurance will cover, or mostly cover out of network. My daughter's current therapist is amazing and she's in private practice. Her rates are actually lower than what insurance was paying the in network psychologist.

Good luck.

[PinkyandtheBrains.]

We found a therapist  via pediatrician referral. 

 

Asking in a a trusted group of local mom friends might help too. 

[AmandaVT]

2 hours ago, Mimm said:

Availability. I have had bored schedulers tell me it would be a year before my suffering child could see anyone. The apathy you meet with in the mental health world is just... lovely.

Good luck.

1

 

This is so true! I've been helping cover our phones for the past few months and I can't tell you how many times people are grateful that I even bother calling them back, even if it's just to let them know about our wait list and to offer up some therapist names who may have openings. One woman I spoke with last week told me she called 20 different therapists and our office was the only one that called her back. I come from a sales background and it would never occur to me not to get back to clients in a timely fashion, so I'm basically horrified at the industry standards.

[Lecka]

An initial screening is probably not going to be a full work-up. A screening may consider whether a full work-up is needed and what it would entail.

It also might be to just ask “what are our goals here” and talk about how to start out.  

That is what I think of for an initial screening.

I think it’s more to think about next steps and get a general idea.

The thing about “getting a full work-up” is that there are so many things that could mean, and somebody decides what will be appropriate for different people.  Unless you have already been funneled toward a certain direction, not everyone who walks in the door would probably have the same things in a full work-up.  

And then for example — a pp said play therapy worked well for their child aged 9.  But for another child aged 9, the therapist might have made a different choice.  So that decision-making process of “what direction to go in here” I think would be part of an initial screening.  

But sometimes it can take getting to know a child over a little time before someone can know what direction to go in for a full work-up.  

It just depends.  I think sometimes they can tell very quickly, and other times they need more time.  

Edit:  I think a lot of frustrating vagueness is normal *at first* but then within 2 months there should be a sense of goals, direction, or something.  

Edited January 17, 2019 by Lecka

[historically accurate]

I have all of my kids in therapy due to a traumatic event. I need to find one for myself, but due to finances and time, I have not. 

Here's how we found ours:

• One was recommended by the neuropsychologist who did testing and said therapy for anxiety would help. 
• One was recommended by our church. 
• One was recommended by current therapist since she was going on maternity leave. Replacement therapist specializes in trauma so she is moving into trauma therapy now that original therapist is back. 
• One was recommended by school counselor. 

We've been lucky. Our insurance has been great, but that is changing. DH's work switched insurance company on January 1. Actually, today, my sole job is to plead our case not to have to switch out the trauma therapist and not be charged out-of-network. They apparently do that sometimes, but you have to basically beg. 

We've had 4 run-ins with counselors who were not a fit. One was on the short list from the church. DD saw her 3 times, and she begged not to go back. The county office's trauma therapist refused to work together with DD's regular counselor. One was recommended by a current therapist for trauma therapy - she was just really, really weird (I thought so, and my teenager doubly so). One was too "babyish" for a super mature, no sense of humor teenager.  

When I call, I ask if they take my insurance, give a brief run-down of areas to focus on, and ask if I can meet with them first. I've been doing this long enough that I know if it'll be a fit for my kids.