Published on 12, July, 2020
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.
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.
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...
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.
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.