{"id":33809,"date":"2019-01-12T11:30:09","date_gmt":"2019-01-12T11:30:09","guid":{"rendered":"http:\/\/counsellingtu.onpressidium.com\/?p=33809"},"modified":"2023-08-15T12:00:13","modified_gmt":"2023-08-15T11:00:13","slug":"counselling-clients-with-autism","status":"publish","type":"post","link":"https:\/\/counsellingtutor.com\/counselling-clients-with-autism\/","title":{"rendered":"Special Edition \u2013 Counselling Clients with Autism"},"content":{"rendered":"\n\n\t\t\t\t\"Counselling\n\t\t\t\t<\/a>\n\t

Special Edition – Counselling Clients with Autism<\/h1>\n\t
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<\/div>\n\t\"subscribe_itunes<\/a>\n\t

During the UK academic breaks, Rory Lees-Oakes and Ken Kelly produce occasional special editions of the Counselling Tutor Podcast, in which they provide a ‘deep dive’ into a specific topic important to counselling and psychotherapy.<\/p>\n

In this episode, Rory talks with Angela Maughan about her experiences with autism as both a counselling client and student counsellor<\/strong>. Angela also offers helpful information and insights to remember when counselling clients with autism.<\/p>\n\t

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Angela was diagnosed as having autism<\/strong> in her early 30s, and has a son who is autistic. Prior to her diagnosis, she experienced a range of mental-health services, including counselling.<\/p>\n

She is now training to be a counsellor herself<\/strong>, with the aim of counselling autistic teenagers and adults<\/strong>. She runs a support group for people with autism in Gateshead in the UK.<\/p>\n

Members of our Facebook group<\/a> – which includes over 20,000 people (students, tutors and qualified counsellors) interested in the world of counselling and psychotherapy – were given the opportunity to suggest questions that Rory would put to Angela.<\/p>\n

These show-notes summarise the points covered in the discussion on counselling clients with autism and are not a full transcript; please listen to the podcast itself to hear the detailed version.<\/p>\n\t

Counselling Clients with Autism: Q & A Summary<\/h3>\n\t\n

A: Different people prefer different ways. Personally, I say that I have autism, but some people prefer to say that they are autistic.<\/p>\n

It is very much a personal preference<\/strong> – so please always ask the individual person about the language they would prefer you to use in referring to their autism<\/strong>.<\/p>\n

Taking the time to do this can really help to build rapport<\/strong> at the start of the counselling relationship.<\/p>\n\t\n

A: Autism is a neurodevelopmental disorder<\/strong>: this means that our brains are wired differently<\/strong> from those of people who are neurotypical.<\/p>\n

It can be very stressful to live with autism<\/strong> – everyday tasks that may seem easy for a neurotypical person often feel overwhelmingly complex for someone with autism.<\/p>\n

It can affect our cognitive and executive functioning, meaning that we forget things and are more prone to accidents<\/strong>.<\/p>\n

Because this can be really challenging, we are often good at masking our struggles<\/strong> – but this also involves a lot of extra effort and so can be really exhausting.<\/p>\n\t\n

A: Most of my counselling was before I was diagnosed as having autism.<\/p>\n

I had been serially labelled with a range of other conditions<\/strong>, which led to me experiencing anxiety<\/strong> and low self-esteem<\/strong>. In fact, these are common comorbidities of autism<\/strong> – as are ADHD [attention deficit hyperactivity disorder], OCD [obsessive compulsive disorder], PTSD [post-traumatic stress disorder], epilepsy, pathological demand avoidance, chronic fatigue syndrome and fibromyalgia.<\/p>\n

As well as epilepsy, PTSD and fibromyalgia, I myself also have migraine. Many of these conditions relate to the sensory overload and exhaustion that come with living with autism<\/strong>.<\/p>\n\t\n

A: I have had a range of types of counselling and counsellors, each with its own strengths but also frustrations.<\/p>\n

CBT<\/strong> [cognitive behavioural therapy] was particularly frustrating<\/strong> – many people with autism struggle with the homework tasks<\/strong> for this.<\/p>\n

This can lead to more anxiety – and I even had letters sent to my doctor by the therapist saying that I was being non-compliant.<\/p>\n

I have also struggled with talking therapies when a phrase used is ambiguous<\/strong> (it takes a lot of effort for me to work out what the therapist means) – and when silence is used<\/strong> (it made me feel awkward and panicky, and so overwhelmed).<\/p>\n\t\n

A: The most important thing is to build rapport<\/strong>.<\/p>\n

Take the time to get to understand about their autism<\/strong>, how it affects them, what they need and what to do if they reach crisis point<\/strong> in the session.<\/p>\n

Be open to the idea of using forms of communication other than words<\/strong> – for example, offer the opportunity to draw as a way of expressing emotions<\/strong>.<\/p>\n

If you use silence<\/strong> in your work, then explain to the client at the start about this<\/strong> – how it works and its purpose.<\/p>\n\t\n

A: It really means feeling overwhelmed<\/strong> in the session – having a sensory overload<\/strong>.<\/p>\n

Visible signs<\/strong> to the therapist might be that the client begins to fidget<\/strong> or that their voice changes<\/strong>. They might even sound aggressive, without meaning to<\/strong>.<\/p>\n

Another sign might be ‘stimming<\/strong>‘ [e.g. hand-flapping, rocking, spinning, or repetition of words and phrases].<\/p>\n

The therapist can help by noticing this and letting the client slow down or take a break from talking<\/strong>.<\/p>\n

Useful activities can include using something soft and tactile<\/strong> (e.g. having a blanket in the session) for comfort, playing with lego<\/strong> or doing a puzzle<\/strong>.<\/p>\n

I have also found writing<\/strong> a useful activity to help me identify my emotions – either on a whiteboard<\/strong> in the session or through journaling between sessions<\/strong>.<\/p>\n\t\n

A: I have tried quite a lot of different approaches, including CBT, person-centred therapy and DBT [dialectical behaviour therapy]. Each has had pros and cons really.<\/p>\n

For example, not feeling judged is great in person-centred therapy<\/strong> (and such a contrast to much of life in the outside world for a person with autism), but the silences can be hard to handle<\/strong>.<\/p>\n

DBT helped me with interpersonal relationships<\/strong>, but again I found the paperwork and homework heavy<\/strong>.<\/p>\n

Overall, I have taken bits from each therapy that have worked for me, using an integrative approach<\/strong>.<\/p>\n\t\n

A: Generally, I’ve had eight, ten or twelve sessions.<\/p>\n

The beginning was always hard<\/strong>. I often used scripted responses<\/strong> – in other words, I’d say I was fine when actually I was struggling.<\/p>\n

One counsellor I had took extra time to really get to know me<\/strong>, even adding some extra sessions to the usual number to allow this, and that was amazing<\/strong>.<\/p>\n

As for ending<\/strong>, it’s important to me to have time to prepare for this and not be taken by surprise<\/strong>. I think it’s really useful to remind the client each time what number session they are on<\/strong> and how many they’ve got left.<\/p>\n\t\n

A: It’s really important to me to have natural light: fluorescent light is unpleasant and overstimulating<\/strong>.<\/p>\n

I feel vulnerable on a hard, upright chair – a soft seat or couch is much better<\/strong>. It also gives me something soft to touch<\/strong> (especially if there are cushions) if I start to feel the need to calm myself down.<\/p>\n

I once was in a room where there was a salt lamp<\/strong>, which I really liked.<\/p>\n

Having a student sitting in would be extremely anxiety-provoking<\/strong> (though I might not be able to tell you this, instead resorting to a scripted response).<\/p>\n

And try to avoid change to the room<\/strong>: this is hard to cope with.<\/p>\n\t\n

A: Take the time to learn about the client<\/strong>, about how autism affects them, and about their interests and needs.<\/p>\n

Consider doing some additional training to help you learn more about neurodiversity<\/strong>, so that you can relate better. Don’t rely on TV programmes to educate you!<\/p>\n

Also, support the client to work on expressing their feelings<\/strong>, for example through drawing or using emotion cards<\/strong>.<\/p>\n

Above all, remember that the therapeutic relationship is key<\/strong>.<\/p>\n\t

You can download Rory’s handout on counselling clients with autism here. Alternatively, it is available in the Handouts Vault<\/a> and Counselling Study Resource<\/a> (CSR).<\/p>\n

We would like to thank Angela sincerely for sharing her experiences with us.<\/p>\n\t\t

Free Handout Download<\/h3>\t\t\n\t\t\t

Considerations When Working with Clients with Autism<\/p>\n\t\t\t\n\t\t\t\t\t\tClick Here to Download Free Handout\n\t\t\t\t\t<\/a>\n\t

Links and Resources<\/h2>\n","protected":false},"excerpt":{"rendered":"

Special Edition – Counselling Clients with Autism During the UK academic breaks, Rory Lees-Oakes and Ken Kelly produce occasional special editions of the Counselling Tutor Podcast, in which they provide a ‘deep dive’ into a specific topic important to counselling and psychotherapy. In this episode, Rory talks with Angela Maughan about her experiences with autism as both 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