Supporting Adult Autistic Mental Health
Person-Centred, Cognitive-Behavioural Counsellor/Therapist
What is Autism-Informed Therapy?
There is growing awareness in the field of counselling/psychotherapy of the need to be more Autism-Informed. These are my current thoughts, very much ongoing work in progress.
As an autistic person, working as a therapist with other autistic people, I understand Autism-Informed Therapy (or Counselling, or Psychotherapy) to simply be therapy that sees Autistic Neurodivergence positively rather than just as a problem, and adapts therapeutic approaches & goals to the particular ways autistic people process the world, especially the social world.
For me, Autism-Informed Therapy isn't about helping an autistic client to not be autistic, but is about helping them, as an autistic person
- to better understand, and live more happily and productively within, their autistic identity
- to recover from & manage the life issues & mental health problems they bring to therapy (e.g. Anxiety, Depression, Low Self-Esteem, Addictions, Complex PTSD, Relationship Issues, etc). Often these are partly the result of having to adjust in unhealthy ways to a largely unaccepting world.
In therapy, autistic clients need, of course, to be met and appreciated as the individual they are, with their unique goals, strengths, and history. A practical, relatively structured, problem-solving approach is often also welcome. In my work, I take a pragmatic, pluralist therapeutic approach, which tries to be:
- Person-Centred in order to convey proper appreciation of the client's individual perspective, and help the client understand themselves better through the use of counselling skills such as Reflection, Paraphrasing, Summarising, Reframing, Self-Disclosure etc.
- Motivation-Focused in order to ensure that therapy tracks the personal values & life goals of the client
- Strengths-Focused to counteract the invalidation & disempowerment experienced by many autistic people
- Trauma-Informed given that many adult autistic clients have had multiple traumatic experiences as they tried to survive in a largely unaccepting world.
Building on these foundations, elements of various Cognitive Behavioural Therapies (including "third generation" CBT approaches, such as Compassion-Focused Therapy, Dialectical Behaviour Therapy, Acceptance & Commitment Therapy, Schema Therapy) can often be useful and relevant, as these approaches tend to be:
- issue-focused, skill-focused, & problem-solving
- concerned with internal processes of thinking, meaning, interpreting, feeling etc, rather than just behaviour
- structured, psychoeducational, coaching, experimental
- explicit in ithe rationale for any therapeutic work that is suggested
- tried and tested in relation to many of the issues autistic adults struggle with, e.g. anxiety, depression, low self-esteem, eating disorders, etc.
A framework of Evolutionary Theory can also be valuable, as it assumes that diversity in populations is the norm, not the exception (see Irish Centre for Evolutionary Psychology & Therapy website).
See blog post on Autism -Informed Therapy here
*** AITI is a neurodiversity-affirming practice ***
In line with our therapeutic emphasis on the autistic person's internal mental processes, motivations, goals, strengths, etc, AITI does not support the use of primarily behaviour-focused interventions such as Applied Behaviour Analysis.
Why is Autism-Informed Therapy needed?
As more children are being identified as autistic, more adults are also realising that being autistic may make a lot of sense of their life experiences and struggles. Whether they come to therapy to get help in processing this realisation, or whether they are already in therapy for secondary issues such as Social Anxiety, Low Self-Esteem, Addictions, OCD, etc, allowance must be made for their autistic personality, sensitivites, and way of thinking.
While the primary characteristics of autistic neurodivergence are still very much under discussion, an autism-informed practitioner should have in mind characteristics along the following lines:
- Possible extremes of sensory sensitivity (in either direction).
- Heightened awareness of aspects of their environment (especially non-social aspects), and intense interest in exploring and discussing some of these aspects.
- Focus on communication as accurate transfer of useful information (e.g. less interested in small talk etc).
- Independent learners, with detailed memory for areas of interest, along with strong systemising & pattern-seeking tendencies & abilities.
- More motivated by truth, consistency, fairness, rules that make sense, etc, than by social conformity.
- May use stimming behaviours for self-regulation, communication etc.
Autistic: Just one of the many fascinating variations on the theme Human.
About Me -see also eoinstephens.com
BA Psychology, Dip Counselling MA Cognitive Behavioural Counselling MIACP, MACI
I'm a therapist & trainer who has worked in the areas of Counselling/Psychotherapy, Mental Health, & Disability for over 30 years, specialising in an individualised, integrative approach to Cognitive Behavioural Therapy.
I've been particularly active in the field of Behavioural Addictions, and received the Irish Association for Counselling & Psychotherapy Carl Berkeley Memorial Award in 2010.
I'm currently focusing my attention on understanding the problems faced by autistic adults, & their specific therapeutic needs. I'm autistic myself, having made the discovery in late adulthood.