Supporting Adult Autistic Mental Health
Person-Centred, Cognitive-Behavioural Counsellor/Therapist
What is Autism-Informed Therapy?
Autism-Informed Therapy is a phrase that's gradually becoming more used in the field of counselling & psychotherapy. What it consists of, or should consist of, are very much work in progress and under discussion (ideally informed by research). My thoughts on it are just my own current ones.
As an autistic person, working as a therapist with other autistic people, I see Autism-Informed Therapy (or Counselling, or Psychotherapy) simply as 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.
Autism-Informed Therapy isn't about helping an autistic client to not be autistic, but about helping them as an autistic person to better recover from & manage the life issues & mental health problems they bring to therapy (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.
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, and intense interest in exploring some of these aspects (and discussing them with others), especially non-social aspects (i.e. less interested in gossip, etc).
- Focus on communication as accurate transfer of useful information (i.e. less interested in small talk etc).
- 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.
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. So overall, from the point of view of therapeutic approaches, I would suggest that AIT needs to be:
- Person-Centred in order to convey proper appreciation of the client's individual perspective
- 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 Cognitive Behavioural Therapy can often be useful and relevant, as this approach tends to be:
- issue-focused, skill-focused, & problem-solving
- concerned with internal processes of thinking, meaning, interpreting, feeling etc, rather than just behaviour
- structured, psychoeducational, & experimental
- explicit in its 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
Elements of "third generation" CBT approaches, such as Compassion-Focused Therapy, Dialectical Behaviour Therapy, Acceptance & Commitment Therapy, Schema Therapy, etc, can also be helpful.
A framework of Evolutionary Theory can also be helpful, as it assumes that diversity in populations is the norm, not the exception (see Irish Centre for Evolutionary Psychology & Therapy website).
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.
See blog post on AIT here
Autistic: Just one of the many fascinating variations on the theme Human.
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.
(see also eoinstephens.com)
Eoin Stephens MA, 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.