Atelophobia - A fear of making a mistake

Hello , I am asking for any advice of ideas / support services. 

I support this fantastic individual who is embarking on his employment journey - however in work trials or work experience situations he is  getting very upset when he thinks he has made a mistake - its totally expected in all the situations he has been in as its part of learning however he gets incredibly upset when he thinks or has made a minor mistake - he removes himself from the situation and isolates himself for the remainder of his day to decompress. I want to help / support of at least see if another support service can help him - its barrier that's holding him back securing employment and he wants to see if we can work through this or at least come up with a way to cope better  when he feels this way.   His potential employers have made many reasonable adjustments and are allowing us to try whatever we want to make this work - we can not always leave a task and go home.  many thanks 

  • It would be worth asking the GP what help would be available. I know of an autistic man who had CBT to help with specific difficulties and it was very successful. It requires willingness and intent to engage in the therapy and to complete the homework, so the person has to want to engage in the process. CBT is the NHS gold standard first line of treatment for depression and is recommended for anxiety and issues around self esteem. I have found it useful for me, but if I was doing it again, I would definitely seek a therapist who is experienced in working with autistic people and who aligns with the values of organisations like the NAS and NHS. 

    I wonder if there would be an opportunity for your individual to observe other people role playing work scenarios? Perhaps he has already observed these during work trials, but it could be useful to do more work in that area.

    Here is a link to a recent article in the journal Clinical Child Psychology and Psychiatry which looks at CBT efficacy in young people. You don’t say how old the individual is but I imagine it might give you an idea of the likely usefulness of CBT or an adapted form of CBT. journals.sagepub.com/.../13591045251314906

  • Personally I'm dubious about the value of CBT, especially in people with ASC. You could try asking him what the worst thing that could happen to him if he makes a mistake, allow him to talk through possible scenarios, is it also possible that he made a mistake once and was unduly punished for it? I suspect that there's a reason behinf this fear and until you get to the bottom of it, then it's always going to be in the background waiting to ambush him. Ask him how certain words make him feel, where the feeling is located in his body, assume that position yourself so as you can feel the stress points, try words like wrong, mistake, accident and bad. I get that his fear is so overwhelming that he has to go away and get himself back together, I used to be a bit the same, I sometimes still am. I think it's a very autistic thing to beat yourself up about things you've done poorly or even things you might have done to upset someone. His fear really needs to be understood, before it can be dealt with..

  • The NHS normally offers talking therapies such as CBT to help people who have trouble dealing with phobias such as Atelophobia.  I'd suggest he speaks with his GP and asks to be referred to the appropriate service in his area.  He should also be able to self-refer if he prefers.