Mental Health Therapy with the Autistic Client

Assessment of Clinical Spaces for Autistic Clients

Executive Functioning Assessment (Endow, 2021)

Core Area System of Support (CASS)

In the field of therapy, Autism is relatively a newer-on-the-scene diagnosis. It has a short history in the DSM, first appearing as a diagnostic entity in 1980. Before that it was called Childhood Schizophrenia. Since then, Autism as a diagnosis has undergone multiple changes. In this presentation, Judy will track those changes along with their significance and implications for therapists today.  Additionally, the limitations of the DSM will be juxtaposed with neuro-affirmation of autistic neurology.  With this understanding in mind, the trainers will go through an example of a framework to use in establishing therapy sessions with an autistic client and will provide an example of a first session with a client.  Then, Lisa and Sharon will delve deeper into the beginning considerations when working with autistic clients. They will address topics such as setting up the environment for success and determining appropriate therapeutic goals with clients. 

1.  Clinicians will obtain the background knowledge of the DSM diagnosis of Autism and the clinical implications that history has on treatment of autism and mental health disorders. 

2. Clinicians will feel confident setting up initial sessions with autistic clients. 

3. Clinicians will have the tools and knowledge to evaluate their current clinical settings and identify specific changes to make the setting safer and more welcoming for autistic clients.

Therapists who see autistic individuals in their mental health practice need to differentiate whether the presenting symptoms are a comorbid DSM diagnosis or are better explained by autistic style of thinking, way of handling information (taking in, processing, storing and retrieving information), sensory differences, trauma impacts, or other autistic attributes. This section will cover this topic, delivered using a combination of slide presentation and interactive discussion with all three presenters. The section will include use of assessment tools along with adaptations needed for clinicians to successfully use commonly implemented assessment tools with autistic clients.

Presenters will move into a discussion about common DSM diagnostic checklists, specifically applying concepts from the introductory series to the DSM diagnostic entities. Those concepts are:  

•     Autistic Life Stressor Considerations

•     Autistic Trauma Considerations

•     Autistic Style of Thinking and Handling Info Considerations

Specific case examples will be used to illustrate the many aspects of differential diagnosing of autistic attributes from comorbid DSM diagnoses when doing therapy with autistic clients.

1.   Clinicians will develop an understanding of the autistic traits that might overlap with other DSM diagnoses.

2.   Clinicians will be able to adapt commonly used assessment tools to make them more accessible to their autistic clients. 

3.   Clinicians will feel more confident determining when an autistic client also has a co-morbid mental health disorder.

Part three will include a discussion of strategies for adapting a variety of common therapeutic modalities for the autistic neurology.  Some of the modalities explored will include:  CBT, DBT, Mindfulness, Expressive Therapy Modalities, ACT, and Solution Focused Therapy.  The trainers will examine the use of techniques considered to be evidenced-based practices through a neuro-affirming lens and how utilizing these practices can help make mental health treatment more accessible for autistic clients.  This section will be delivered using a combination of slide presentation and interactive discussion with all three presenters.

1. Clinicians will be able to identify strengths and weaknesses of common mental health treatment modalities as they relate to autistic clients and ways to assess the appropriateness of fit.

2. Clinicians will feel confident adapting current treatment modalities used in their clinical practice to align with autistic neurology. 

3. Clinicians will be able to identify treatment techniques that came from the field of teaching autistic people and be able to apply them to mental health treatment.

In this final section, the presenters will use case examples to integrate information learned in previous sections on how to set up the therapeutic environment and establish therapeutic goals, how to differentiate presenting symptoms, and how to adapt therapy modalities with autistic clients so that participants walk away with practical, ready-to-use tools and strategies to start implementing in the clinical setting.  This section will be delivered using a combination of slide presentation and interactive discussion with all three presenters.

1.   Clinicians will be able to identify how treatment modalities were adapted and individualized for autistic clients in case examples provided.

2.  Clinicians will feel confident integrating the information from previous sections into their clinical practice.

3.  Clinicians will be able to identify other resources they can access to continue learning about the intersection of autism and mental health disorders.