Therapeutic Adaptations for Autism - and where do you find them?

I have been struck by how many of us on this forum have issues with Mental Health, yet how many say that counselling and CBT etc haven't been much help.  I have to say that getting the right support for my phobias and anxiety was my primary driver in the investigations which lead me to the possibility that I am autistic, and has me on the road to an assessment.  Nothing offered by MH services either helped me or made the slightest sense in relation to what I am actually experiencing.

With that, I've been reading around adaptations of counselling and psychological therapies for autism.  One example is below. Generally these pieces include thoroughly sensible ideas like:

  • Ask very specific questions
  • Use images
  • Adjust the lighting etc
  • Allow A LOT more time to understand ideas bottom up through the detail and make connections
  • Allow A LOT more time to identify and analyse emotions and sensations
  • Don't assume certain behaviours are a mark of lack of co-operation
  • Don't assume anything from the patient's body language etc until you check with them
  • Don't expect them to be able to talk if in melt down

Personally, I have found NHS general MH services have done more harm than good; I'm in their naughty box because I can't seem to think what they think I ought to think or how they think I ought to think it, or feel what they think I ought to feel.  I feel I've been continually talking at cross purposes with them. They want to know what I think and feel, so I knock myself out to be honest and tell them everything I think I know and understand about my situation, only to be scolded with: "I don't know why you think I need all this detail". I tell them that my mother seems to be suggesting that I rejected her as a tiny baby (I didn't want to be hugged), and they try to pressurise me into saying she must have abused me, which just isn't true. And then I'm thought of as unco-operative for rejecting the premise. I've gone into melt down in there and then been asked "So, what's going on?", when I didn't know and was struggling to speak at all anyway.  My failure to come up with an answer is deemed evidence I don't want to "put the work in".  The list goes on, but looking at it now in hind sight, ALL of the problems with the therapy seem to me like a litany of everything ever that can go wrong in an NT / ND dialogue.

I've been left to figure out what's going on for myself, though as I look back, given the very large number of autistic behaviours I had in there, I'm disappointed the possibility never occurred to any of the professionals I dealt with. - Never mind, it looks like I have the answer now.   

Quite apart from the fact that a failure to diagnose autism would mean that the true cause of anxiety can be missed, it only stands to reason to me that a person who does not process either thought or sensory information in the same way as NTs, won't respond, or respond as well, to therapies designed for them.  I am thus very interested in how therapies can be adapted effectively.  Once over the diagnostic hurdle, I will of course need to find something that does work for me.

So, I am interested to know what other people are being offered and whether it's helpful.  Have you had your frustrations trying to communicate with mental health professionals?  Has anyone made any effort to adapt their practice for you?  What adaptations do they make? Are the specific mental health issues of autism even on the radar of the services in your area?  Where DO you find the right kind of support?

What Works When Counselling Autistic Lives? | Open Forum Events

  • I always found counsellors sweet but not terribly useful prior to this guy. Lots of just 'tell me about it...', so I tell them...and what? Changes nothing.

    This guy has been aware that autism is a likely issue from session three, when I realised, though, and he's much more structured, very clear about what he's trying to achieve and always checks our mutual understanding of what's being said. No talking at cross purposes, no airy, fairy "what are you feeling?" questions and everything in a tidy, logical order. Much better.

    I don't know whether that's his natural counselling style or whether he's doing his home work for my benefit or just has experience of ND people before, but he is better.

    I'm going to google the other therapies you mention, now.

  • I found counselling really difficult and only had one session. It might have been the person I had but there was no structure.

    CBT was useful to some extent, mainly for generalised anxiety and "worry".

    I have heard ACT and CAT therapy are more useful for AS individuals. It was recommended by the people who assessed me but I've yet to look into it.

  • In a way it's comforting to hear so many of you guys experience the same problems as I've had with CBT and counselling, but something needs to work and we need to know what that something is.  My failure to get better certainly isn't for lack of wanting to or willingness to engage, whatever they think, but the answers need to stack up logically and concretely taking account of all the detail.  I can't DO airy fairy and vague.  And that's how most of what I've had seems and it doesn't help me.

    I don't think my counsellor can change much for me at present, but he is at least making me feel more supported and is someone I can bounce some of these experiences off and because he's private he can be there for the long term. He has been very good at thinking about his question styles, pace and order of ideas carefully to suit my needs.

  • i found my mind was way to strong for my counsellor. So after 8-10 weeks nothing was achieved at all.  

  • Brilliant. Thank you so much

  • True. My complaints are all with the NHS services really. They were appalling when my son was ill. They were appalling with me. My husband got to the stage where he wouldn't call them when I was in crisis any more because he felt they made matters worse.

    To be fair, no one knew that autism was part of the picture, but looking back, I'm shocked nobody suspected anything. They have a real 'blame the patient' culture. I was even asked that question session one: 'whose fault is it, if it doesn't work?'. I don't think that's an ok question for anyone.

    Just before the penny dropped for me, I had engaged a private counsellor. He's been great, actually, in adapting to my thinking styles; but long term, I know I'm going to need something specifically targeted at my complex medical phobias and a shed load of support to manage in medical situations and that's going to have to be geared toward my autism. I very much doubt the NHS is going to help me at all, so I'm going to need direction as to what to get for myself.

  • I'm checking with the moderators about telling you about researchers as I know that most of the rules apply to private messages also - I've asked if they have a page on genuine researchers that I could share to the group or that they could.

  • The problem I've found is most NTs can't grasp the world we live in - they view our world through their experience so if you're paying for sessions, 2 or 3 are wasted just trying to explain the battle terrain before you can even begin to discuss the issues.

  • And a further thought which just came to me, is maybe I need a therapist who is themselves on the spectrum.

  • I can only get it work from my PC, not my mobile. I'll have go when I log on my machine

  • I can't see how to PM you - do you want to try to PM me and I'll reply?

  • I'd be interested in checking them out if you can pm me the name.  I'll take care to check out their credentials

  • I know that a couple of research charities are working on some therapies for different neurodiverse people such as those with autism, people with hypermobility.  I won't share them as their pages have donate buttons/requests for research participants.  Check it's a registered charity and a genuine website before getting involved with anything though.

  • i like the content in the link