Problem with CAMHS advice on dealing with her anxiety and what is Anxiety Gremlins at CAMHS?

[Orchid2016]

 

My daughter had an assessment with CAMHS and today we have been informed that she has been referred to their in house support team called Anxiety Gremlins.  What exactly is this? When I asked if this was CBT I was told it was something similar?  Has she been given some watered down form or counselling?  He also told me not to do anything to help her anymore, like with help getting dressed, eating ect.  I've decided to take the advice to some degree but I will have to help her eat and drink.  As for getting dressed it means she won't be able to do this herself due to her anxiety being so bad and unfortunately it means her dropping out of school.  What would you do if it was your child?  I have been helping her as a way to support her in getting to school as much as possible but if she doesn't go she has more time on her hands to have thoughts.  I suspect we haven't really been heard properly at CAMHS, he said the referral only came from me despite the fact school had been in contact and also made a referral to them.  Apparently they have no record of it?  Something also that I disagree with is he is suggesting his team of experts believe it to be anxieties related to home as that's when she carries out the rituals mostly and he saw no evidence of OCD.  He says not chronic OCD as she isn't doing it all the time.  She does it out the house as well, my mums seen her do it at her house and also she does it at school but not as much as she hides it from people at school.  Her problems started when she moved school and has had to drop out of History due to the thoughts she has been having.  Things are so bad a home, i've been having to everything, dressing her, cleaning teeth, feeding her, helping her get a straw in her mouth, walking her to school on days she can get up, the list is endless.  If its not chronic OCD, its chronic something because she isn't going to school anymore and only made it into school 3 hours last week despite my efforts with her.

 

Has anyone got any suggestions or experienced similar issues with CAMHS?  I've been in contact with my MP and school have been made aware of this problem we have had thrown onto us.  I suspect its a lack of funding and CBT must be rationed for the lucky few.  

Edited March 27, 2018 by Orchid2016

[snowbear]

Hi Orchid,

There's a book called 'Starving the anxiety gremlin' which is an explanation of OCD for children and an outline of the CBT approach to stopping compulsions (starving the gremlin.) I don't know for sure, but I suspect if your local CAMHS have an in-house team called that 'Anxiety gremlins' it will be a support team using CBT to help your daughter. If in doubt, phone them up and ask.  

The advice you've been given about not helping her (not doing things for her) is spot on. Trouble is her compulsions affect the most basic tasks of eating and drinking and you've got to keep her alive while also not helping her avoidance compulsions by doing things for her - it's a fine line and a tricky tightrope for p arents to walk. It's easy for a stranger to say 'Let her starve. If she goes hungry long enough she'll overcome her compulsive fear and eat.' There's an element of truth in that, many children do manage to prioritise survival over their uncomfortable feelings and fears, but it's a hard thing to ask a parent to watch their child suffer temporary starvation, even if the suffering will help them in the longer  term. Some compromises may need to be made and you must decide what those have to be. 

You've done well to keep her at school as much as possible. It's my personal opinion that not letting a child drop out of school because of OCD is helpful in getting them to face up to the reality that compulsions and the necessary tasks of everyday life don't mix well. All I can say is my parents would have taken me to school half dressed and hungry and left me at the school gates to face the peer embarrassment of not having dressed and fed myself. (Actually they did drag me to school once partially dressed when my rituals took so long it threatened to make my brother late for school or them late for work. I quickly learned avoidance wasn't the way to get around compulsions.) But that was a different era when attending school was as basic a personal responsibility as eating. These days, some parents don't view school as an everyday essential of life so they limit the challenges their child must (initially) overcome to basic self-care.

More time on her hands at home would be a bad thing if you were to continue doing things for her. But why not use the time to get her to do stuff for herself? She's got all day and no deadlines to meet, so it doesn't matter if it takes six hours and several meltdowns to get a bite to eat, a drink and teeth brushed. Make it her choice. She can go to school, with minimal help from mum to get her out the door, or she can stay at home and do a school day's worth of hours doing CBT with mum's guidance.

I probably sound cruel, but if you give OCD an inch it will take a mile. Sooner or later there comes a point where you both need to stop pandering to fear (her OCD fears and your fear of upsetting her) and get on with life's essentials. Yes, it's HUGELY stressful and scary for her, and 50 years on I remember it like it was yesterday, but she has to face it eventually and putting it off doesn't make it easier. The longer it goes on and the less she is forced to do for herself the harder it's going to be for her further down the line. Trust me on that. 

You don't need to be an expert in CBT to do a bit of CBT with her at home. Just setting some boundaries on what you will help with and what tasks she has to start doing for herself again is probably one of the first steps a CBT therapist coming to the home would set anyway. You're going to find you're a lot more skilled in 'CBT' than you ever knew.  

[Orchid2016]

Hi

Thanks for the reply. It was helpful and made me think about the situation from another’s angle. I thought perhaps they would have put therapy in place before tackling with the issues. Anyway ive decided to follow the advice including with drinking and meals. The result has her been doing nothing for herself including no eating and drinking. Only if she is so starving more than the pain of her thoughts. 36 hours without any intake and down at the doctors all morning. Doctor is basically doing everything possible and made referral to peadiactrician. So much for being told it’s not severe OCD. 

[snowbear]

Hi Orchid, 

Sorry to hear your daughter is struggling to this extent. It must be very stressful for you too, but at least your GP is trying to help. If the paediatrician gets involved for her physical health then he will also be able to support your communications with CAMHS and perhaps some good will come of this episode.

Keep fighting! Children suffering just as severe OCD as your daughter have made a full recovery. Never lose hope.