Therapy styles that work for autistic adults

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ratey
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22 Jun 2024, 3:02 am

Hello folks

Just wanting some feedback from those of us that have had (or are having) therapy from a psychologist.

The psych who diagnosed my ASD mentioned that more common types for therapy like CBT are not so effective or even appropriate for people on the spectrum.

My current psych wants to do Schema therapy, which does sound ok :? ... just wondering what others have found that "works"?

Thanks in advance...


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r00tb33r
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22 Jun 2024, 3:32 am

Genuinely curious to know.

Mine sat in front of me calling the EAP service wasting 20 minutes so they could tell her what I already told her. I sat there asking her not to do it, she did it anyway. Then tell me that I'm over time at the end.

She would waste 10 minutes of my appointment with scheduling. I told her to handle scheduling outside my appointment time, let her assistant do it.

At the end of appointments she liked to call time, then immediately ask me a question, and as soon as I start speaking would tell me what a bad boy I am because I'm over time. If I'm over time then don't ask me the f*****g question!



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22 Jun 2024, 3:59 am

Idk to be honest I probably do need therapy, but idk what sort to look into. hell due to my potential adhd that is undaignosed...it is the adhd itself that is contributing to me procrastinating about seeing a doctor about it. LIke seems I am even having a hard time getting to see someone over my adhd concerns specifically because of the disorder as procrastination can be a part of it. So every time I think I should go to a doctor I just procrastinate till I can pretend
to forget..idk why it is so hard to to just go to a damn doctor about this...but I keep procrastinating about it cause I don't know if they will believe me or I feel ashamed deep down inside or what but I am having a hard time with the fact I may have had adhd all along with the autism and even teachers tried to tell my mom but she wouldn't believe it and wanted me to 'just be a kid' I know she meant well but I had problems and her approach may have prevented me from getting some help I could have benefitted from. And now as an adult I am not quite sure how to adress it.


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Fenn
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22 Jun 2024, 1:15 pm

CBT - using thinking to change feelings. Very popular. Has a tendency to assume thinking precedes feelings which is only partially true. Focus on short term behavior and cause and effect, not so good for dealing with childhood issues or accepting ones feelings. Doesn’t deal well with internal conflict. Masking may result.

ACT - more acceptance. Like DBT is essentially behavioralist. More change.

DBT - more open to feelings and acceptance than CBT. More practical ways to deal with hypersensitivity and overwhelm than the other two. Can be a bit ham-handed about pushing Eastern religion practices and language, depending on the therapist.


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MatchboxVagabond
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22 Jun 2024, 1:44 pm

ratey wrote:
Hello folks

Just wanting some feedback from those of us that have had (or are having) therapy from a psychologist.

The psych who diagnosed my ASD mentioned that more common types for therapy like CBT are not so effective or even appropriate for people on the spectrum.

My current psych wants to do Schema therapy, which does sound ok :? ... just wondering what others have found that "works"?

Thanks in advance...

There's a lot of options, CBT is typically too much thinking about emotions to be of any real value, and can just encourage more time spent in the head thinking about what you're doing and why.

I'm not familiar enough with it to have much of an opinion, but from what I see in the description it's not an unreasonable place to start. Sometimes it can take a few different methods to find one that works well. Personally, my bigger issue is being so dissociated from years of masking that focusing on reconnecting my mind and body was a higher priority, but it's really going to depend on the particular individual as no therapy is universal.



r00tb33r
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22 Jun 2024, 5:50 pm

Fenn wrote:
CBT - using thinking to change feelings. Very popular. Has a tendency to assume thinking precedes feelings which is only partially true. Focus on short term behavior and cause and effect, not so good for dealing with childhood issues or accepting ones feelings. Doesn’t deal well with internal conflict. Masking may result.

ACT - more acceptance. Like DBT is essentially behavioralist. More change.

DBT - more open to feelings and acceptance than CBT. More practical ways to deal with hypersensitivity and overwhelm than the other two. Can be a bit ham-handed about pushing Eastern religion practices and language, depending on the therapist.

But does it work?

It all sounds useless to me.



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22 Jun 2024, 10:54 pm

It depends what your therapy is for, whether it's for bereavement, eating disorders, mental illness, addictions, PTSD, CPTSD, ADHD, etc. I don't think there's a one-size-fits-all answer to which kind is best because it depends what types of support we're seeking, how much background or experience (schema) we have with therapy, how much time we're willing to commit to the process, our ability to communicate, and the amount of family or friend support we have tangentially.

It also depends on the type of professional you're seeing. I've worked with Psychiatrists, Clinical Psychologists, Registered Psychotherapists, Social Workers, EAP programs, Day Counsellors, Occupational Therapists, and Speech Pathologists. They all offer different treatment modalities including CBT etc., depending on patient needs.

My best success has been with neurodivergent providers who tailor their approach for me. My current therapist for trauma is a Social Worker and PhD Psychotherapist who is ND. I also had success with a PhD Clinical Psychologist who was an expert in trauma.

I agree CBT is considered ineffective for many ND folks but it might be right for some of us. My experience with ACT was positive. I've done limited DBT and don't feel I need to commit to that. I don't really want to change. I only want to understand, and I've come a long way in that regard with an ND therapist.


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mgurak
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23 Jun 2024, 1:02 am

I found that a combination of DBT and IFS works well for me. That's the approach my therapist and I are going to take. I'm fortunate enough to have found a therapist who works closely with folks with ASD.


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23 Jun 2024, 1:21 am

My wife was a NAMI certified mental health counselor. She concluded that therapy wasn't useful compared to my other options.
I have a large yard and spend a lot of time gardening alone. I think a lot of Aspies would benefit from something like that. Perhaps volunteering at a public garden.
In the past few years I taken up playing golf. For me this a very effective "mental reset switch."



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23 Jun 2024, 1:01 pm

r00tb33r wrote:
Fenn wrote:
CBT - using thinking to change feelings. Very popular. Has a tendency to assume thinking precedes feelings which is only partially true. Focus on short term behavior and cause and effect, not so good for dealing with childhood issues or accepting ones feelings. Doesn’t deal well with internal conflict. Masking may result.

ACT - more acceptance. Like DBT is essentially behavioralist. More change.

DBT - more open to feelings and acceptance than CBT. More practical ways to deal with hypersensitivity and overwhelm than the other two. Can be a bit ham-handed about pushing Eastern religion practices and language, depending on the therapist.

But does it work?

It all sounds useless to me.


It is important to know what you want out of a support professional or helping professional. I have found that all three helped with anxiety and depression. My eval for autism diagnosis said that anxiety is so common with autism the expert (who specialized in autism diagnosis) didn’t even consider it a separate diagnosis.

I have also learned some ADHD coping skills by one therapist who specialized in ACT and ADHD.

What kind of “help” would you be looking for out of therapy? How would you define “work” and “useful” in this context? If you can tell me that, I can better answer your question.


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crisv
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23 Jun 2024, 6:24 pm

To me CBT is the new paracetamol - it helps with the symptoms, but it does not cure.
I found out that most times we have trauma that has been caused by feeling different and not understanding why. Many of us have been abused in different ways. If you have been diagnosed late like me, most problems may come from masking. It's not just being ND and having to learn how to manage social skills. I am at the third therapist in 3 years but I often think that talking to other autistics, reading and watching some YT is more effective.



r00tb33r
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23 Jun 2024, 11:02 pm

IsabellaLinton wrote:
My best success has been with neurodivergent providers who tailor their approach for me. My current therapist for trauma is a Social Worker and PhD Psychotherapist who is ND. I also had success with a PhD Clinical Psychologist who was an expert in trauma.

Can you tell us more?

How many appointments does it take to see results? How often should those appointments be? What is the structure and duration of each the appointments?



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23 Jun 2024, 11:30 pm

I have had mostly really bad experiences with therapy, but I like my current therapist. I think it's more down to the person than the type of therapy, and I would actually be cautious with someone who subscribes to a particular system rather than actually listening and being present and offering their insight. And they also have to be smart and knowledgeable.

I think CBT is particularly bad, but as I said I think any therapy that is too bound by a particular mode is not going to sufficiently oriented toward the person and what is actually going on with them.



ratey
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26 Jun 2024, 8:48 am

Fenn wrote:
It is important to know what you want out of a support professional or helping professional. I have found that all three helped with anxiety and depression. My eval for autism diagnosis said that anxiety is so common with autism the expert (who specialized in autism diagnosis) didn’t even consider it a separate diagnosis.

I have also learned some ADHD coping skills by one therapist who specialized in ACT and ADHD.

What kind of “help” would you be looking for out of therapy? How would you define “work” and “useful” in this context? If you can tell me that, I can better answer your question.


Good questions. I have been to a bunch of therapists over 2-3 decades and have so far been underwhelmed.

I guess right now I want some insight into what about myself is causing me stress or holding me back. Then either/or (1) some strategies to work through our even overcome those things (2) improving my self-understanding so I can be more forgiving of what I see as shortcomings.

The Clinical Psychologist I'm seeing right now seems a good fit, and he's ND. We started Schema therapy today and I think it had the potential to achieve points (1) and (2). I'm pretty new to the idea of being ND (although I have suspected it for several years) so just talking to someone who gets it helps. I'll see how it goes...


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ratey
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26 Jun 2024, 4:20 pm

bee33 wrote:
...I think it's more down to the person than the type of therapy...
...
I think CBT is particularly bad...


Absolutely it's about the therapist as a person! If I'm going to be vulnerable with a therapist, we're going to have to get along and I need to know that I can trust them.

I suspect CBT is so widely used (at least in Australia) because it's "evidence-based", mainly for treating depression I think. Of course I'd bet the research that provided the evidence was done with mainly neurotypical subjects :|


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26 Jun 2024, 7:47 pm

I have a green thumb so it is very relaxing to go outside to the garden and see what plants are blooming today.

With golf, I'd often play for best shot of the round. Out of fifty swings I'd usually make one or two good ones.
Sometimes I'd see something unexpected. Maybe a bird that I've never seen before.