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CBT

Marjorie195

CBT is often mentioned here, as the treatment most helpful for those on the spectrum. I think that it is being built up in the minds of some people, to be a miracle remedy that will change their lives easily.

CBT is more, an idea about how you can move forward in life. It rarely changes anything on day one, and needs to be worked at, harder than you can imagine.

I had, what I now know to be CBT many years ago. The only thing that changed was that I acquired hope for the future. It was more like taking a fork along a footpath, than some life changing experience.

It is , for the NHS, expensive, and is therefore brief. You are given a set of ideas, and some practical examples of how to use them, then you are on your own. It is you who has to learn how to do it. I had some brief follow up, a year later, with group discussions about how people changed their attitudes, but that is it.

For those who want to try it, I think the best approach might be, to put into practise one piece of advice, given during a consultation, and noting down how you went about changing this one aspect of your life. Give examples of how this has improved one or two situations, you have found yourself in, then ask for more advice.

So many people who have CBT say nothing much has changed, and I need more now. They can follow the specific examples for them, given in training, but do not pick up on the need to implement it themselves in other situations.

If you can show that you have benefitted from help given, and can use it in other situations, then you will be able to access more help, even if it is one new idea, from a health worker every now and then. Too much at once, can be overwhelming, it is fairy steps, not great leaps forward. I still use my training, now knowing the notes by heart, and still go wrong, often, and benefit from a push back in the right direction.

My CBT was for depression and anxiety, but that is what a lot of us have, and as I am undiagnosed, it was not aimed at problems related to asd. That does not mean that it is of no value. I have found that  life changing, eventually.

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  • in reply to PINARELLO F8

    This post was from 2 years ago, how are you doing now? I was a bit shocked to read that you started CBT therapy and then the same therapist decided to abandon CBT and do an Autism diagnosis? That doesn't sound right to me. 

  • in reply to Wendy

    Hi ,

    You may like to have a look at the information on OCD and autism from the NAS website:

    https://www.autism.org.uk/about/health/mental-health.aspx

    https://www.ocdaction.org.uk

    I hope this is useful!

    ChloeMod:)

  • in reply to extraordinaryjourney

    I've just found your post and what you're saying makes complete sense! My 26 year old autistic son had CBT for his OCD and worked for a little bit whilst he was on the course. I found though that because I wasn't allowed to stop with him whilst he was having his treatment, I couldn't help him at home.

    Since then I've been trying to find someone who does CBT specifically for autism, but to no avail! not only that, there is an unmet need in our area for adults with autism.

    And now with this lockdown and all this change, his OCD has now got even worse!

    Is there any good online resources or help I can access or just to be pointed in the right direction?

    Thanks in advance

  • in reply to Trogluddite

    Thank you for your detailed reply, I feel a bit less worried now. For some reason it didn't occur to me that I could ask to defer answering questions until later. I often need to write down how I feel before I can accurately describe it to someone else, which is rarely possible in normal conversation.

  • I had CBT from the NHS because I suffer really badly with anxiety and stress which finished last month.Initially it was supposed to be four sessions,

    The first couple of sessions went well but then we started to explore the fact that I might have Aspergers. This completely derailed the CBT treatment and we spent the remaining two sessions exploring Aspergers. This completely blew my mind and caused my anxiety problems to become much worse.

    Another two sessions were added to enable the autism diagnosis referral to be done, The therapist said that because I was now worse than when I started I would be receiving an intensive 12 week course of CBT but that wouldn't be for 6 months due to waiting lists.

    That was the end of my initial CBT therapy. I left the final appointment in an emotional mess due to having to come to terms with the likelihood of having autism and also I really had felt that at last someone was finally going to help me with my lifelong anxiety issues and they had gone without anything being resolved.

    I tried to get on with life but was starting to really struggle at work having severe anxiety attacks on a regular basis and feeling suicidal. After a week I decided that I couldn't go on in that state any longer so I phoned CBT to ask for additional help (surely they operate an open door policy/duty of care?), they said they woudnt be able to help and to go back to my GP.

    Next day I saw the GP and he e mailed CBT department and asked them to contact me. I waited 5 long days for the phone to ring  but no phone call came so I phoned them back, the receptionist said someone would phone me ASAP. 5 days later they did phone(10 days of waiting is torture for someone who is suffering from severe anxiety and feeling suicidal). They said to read through the notes I was given and phone Samaritans if I got really bad. I asked when I was due to get my intensive 12 week CBT course and was told I woulnt be getting it

    I went back to the GP and asked him where I should go for help if NHS mental health dept wont help - he had no answers so I asked him to sign me off work.

    Ive been off work for 4 weeks now

    Ive had my NHS appointment through - its in 2 weeks

  • in reply to Misheard Lyrics

    A good therapist should not just work for you, but with you. If you have any concerns about how it's going, feel that it's trying to fight the wrong battles, or that certain autistic traits make an exercise particularly difficult for you, don't be afraid to say so. In particular, make it clear that living in a world which doesn't understand autism very well is an ongoing source of stress; unlike more typical patients who are having a short-term blip because of a particular combination of circumstances or trauma. Be honest about any difficulties opening up to the therapist, as this is itself something that the therapist might be able to help you with.

    A few other tips...

    • Set aside some down-time after therapy sessions if you can. Therapy can be cognitively and emotionally demanding. Don't mistake this for a sign that the therapy is not working, it is quite natural after a session to feel burned-out, or to have a million questions rattling around your head. Allow your mind to recover in whatever way works best for you, and don't jump to conclusions about what's happened in a session until the dust has settled a bit.
    • Keep a notebook or diary handy so that you can make notes about anything you want to discuss with the counsellor, or any reactions you've noticed after a counselling session. Counselling will involve answering quite open-ended questions and bringing to mind examples, the ambiguity of which can be difficult for many autistic people, especially when put on the spot during a session. Keeping notes is both a good way to collect these thoughts, and to plot the progress of the therapy; the therapist may even find your notes useful directly if you take them in with you.
    • Asking for the therapist to set something aside until the next session, so that you have more time to think about it, is a good idea sometimes. It's not unusual for autistic people to find talking about their emotions difficult or for their feelings to take time sinking in after an event (what's called alexithymia). Ask to defer something rather than giving an inaccurate answer just because you feel pressured into saying something, and make clear that you are genuinely having trouble answering rather than trying to avoid the question.

    I hope your therapy goes well. I've had mixed results with CBT, though to be fair, most happened before I knew my autism diagnosis. Adapting it to fit autistic traits can make a big difference, in my opinion, and being a pro-active patient who helps to guide the therapist can go some way to doing that.

  • in reply to Misheard Lyrics

    The questions will be different for everybody depending on their needs.

    Best wishes to you. I hope it goes well.

    I am halfway through CBT at the moment. I find it very difficult but it is helpful.

    If your counsellor is any good he/she will give you plenty of excercises to try at home and continue with after the sessions are finished. It won't be easy. But in the long term it could make your life a bit easier.   Slight smile

  • I found this old thread while searching for information about CBT, because I'm going to be getting some myself soon (on the NHS), for anxiety and depression. It's going to be a one-to-one, 6 or 12 week course depending on how well it goes. I've found the replies here helpful already, but I'm nervous about "unloading" to a stranger face to face. I think I do need the help, even if it isn't a miracle cure, but what sort of questions am I likely to be asked? I have to make the most of this, I can't afford private counselling.

  • As a therapist myself in CBT for Childhood Autism, I have found that over th eyears the only way to effectively use CBT is not through 1:1 with a professional but with the primary caregiver.

    There is one thing that many professional miss out on when approaching and ASD child with CBT. What they should be doing, and this is what I do, is I train the parent on a 1:1 to teach the child themselves.

    ASD children have a strong bond with a primary caregiver (either mum or dad for example) and thus, this is the only person who will be able to teach the child any skill that they need. The idea that only professionals can effectively 'teach' actually doesn't work with ASD children. This is why, in most cases, the effect is only temporary.

    Like any of these alternative methods, the key is consistency. Many clients are wrongly told that all you have to do is do the exercises for a short while and you will be 'cured.' This is wrong and completely misguided. To effectively use CBT, it has to be regular and consistent for it to be effective. 

    It is an ongoing method with no end. Once the child is old enough to manage their own barriers, they can continue the work themselves but it is life long. What angers me is professionals in my field who are quick to take the money from the client (privately) and expect that client to be an 'ongoing' income. 

    CBT is useful but as you know, not a cure. The problem is, is that CBT has never been used correctly for Autism, and for that to happen, it has to be modified.

  • One of the issues with CBT is it will help you clear out your mind of "baggage", misunderstandings, persistant anxieties, and may help you manage your circumstances.

    But it generally wont cure poor eye contact, or difficulty with reading and generating facial expressions and body language. So social interaction difficulties will still be there, and will create new persistent anxieties, misunderstandings and "baggage". It wont take away sensitivity to noise, or complex noise and movement, or other sensory environments (it might ease the effects for a while). It wont remove overly focussed thinking (though it might temporarily ameliorate its impact) and likewise it wont cure rigid thinking, or coordination, or management of daily routines.

    Too many people are given CBT and then told its up to them to go away and lead better lives. If the unresolved factors crowd in again, and re-establish the problems CBT was employed to relieve,  they tend to suggest it is your fault, somehow. I think it is particularly cynical they way it is sold to parents as a solution to teenagers behavioural problems, but when the environment changes the problems come flooding back.

    CBT is fine if it is used where it is important and not passed off as a magical elixir for curing autism.

  • CBT is a way of altering how you think.  It helps you to identify negative thoughts + hopefully helps you to turn them into thoughts that at least aren't so negative + hopefully positive.  Saying that, as an NT, I think CBT has it's limitations.  That's why there a lots of other therapies about.

  • I think CBT can help anyone wether on the spectrum or not. However it doesn't help everyone. The most important thing is if u really want to do it and wether u take on the advice.