Autism and therapy: Shifting the focus

There is an exciting change afoot in the therapy world for autistic people. In fact, it’s a change brought about by autistic people who are advocating for themselves. And it’s definitely a movement I want to be a part of. It’s a significant move, away from seeing someone with autism as needing to fit into others’ ways of doing things, to adapt , to mask behaviour, to instead seeing someone with autism as unique and appreciating the differences of the individual.

I think this change started in the larger disability field. We have moved to a more inclusive way of being, though is has taken a long time, and there is still work to be done. So within the autism movement this change kind of seems monumental and familiar at the same time. It feels obvious in our culture that we should be appreciating difference, but my view is that it is only recently that this has been applied to the autism community. The newer approaches that are emerging are not completely different to what was there before, but there are key differences, and some common themes are evident. So if you’re interested in what this looks like, keep reading.

Learning from; not teaching to

When I was at University over ten years ago most of our classes included ‘service user involvement’. This was when a service user for whatever we were learning about at the time would come into lectures and talk to us. Usually they would talk about what it was like to live with a difficulty and their experience of therapy. As a student it was really good to get these perspectives. But that’s generally all they were – perspectives. When I see a client as a therapist now I see them as the expert of their own life. I don’t come in with all the answers. We find solutions together. This is the stance I am seeing now reflected in the autism community. Advocates such as Chloe Rothschild are educating therapists about what works best for them. Chloe is not jut giving her perspective, but is giving expert opinion, teaching courses for therapists. There are many voices like hers, giving feedback on what works and what doesn’t work. As a therapist I find this exciting. Autistic people are the experts when it comes to what is most effective for them, just as I am the expert of my own life, and you yours.

Understanding differences

Another theme I have seen is that autism is being seen differently. The full term ‘autistic spectrum disorder’ perhaps best describes how autism has traditionally been seen. A disorder. And it’s true that having autism can create a lot of challenges. But a question that’s asked more and more is whether these challenges are because it is a disorder, or because of the way our world is configured for neurotypical ways of being. If it’s less about the individual, and more about the world, then therapies should not be about teaching individuals to fit in, but instead teaching the world how to be truly inclusive. Once we see autism as a difference rather than a disorder we also can see the many strengths and unique abilities autistic people bring. Therapies should be about building on these unique abilities so autistic people can thrive in their own way. We live in a world that should be big enough for many different ways of being and seeing, and the autistic community should be an equal part of that.

The right kind of skills

Through advocacy the autistic community is seen more than before. Autism as an identity is becoming more mainstream. There are particular differences in the brains of autistic people, which means different ways of being and seeing the world. Often therapies within mental health are adapted for an autistic client. Sometimes this works well, sometimes not. However what is happening now is therapies are being designed which focus specifically on the problems that are central to the autistic community. For example, the interoception curriculum addresses difficulties accurately recognising body sensations, something up to 95% of autistic people struggle with, and foundational for self-regulation and social skills.

Moving away from compliance

Compliance is something most parents teach and expect of our children. Hopefully this is done with love and connection, but somewhere along the way we are expecting our kids to follow house rules, school rules, social norms and behave in a certain way. Historically, and actually a lot of the time currently, we expect this from the autistic community also. But what advocates are now highlighting is that this doesn’t account for unique differences, preferences and needs. Often the rules we take for granted can act as barriers to the autistic community. An approach that pushes compliance can simply make behaviours worse and lead autistic people to feel more isolated. Organisations like Autism Level Up! are leading the way in teaching professionals and family skills to move away from compliance and instead offer support in a way that is relevant and meaningful.

I hope that this move continues. There is certainly a long way to go, but it’s really exciting to see changes happening. As a therapist I am keen to be a part of it, to learn more and to improve my practice. Please feel free to get in touch if you are autistic, or if you support someone who is autistic. Tell me how I can be a better therapist and advocate for the autistic community. If you are not autistic then take a moment to look at this guide from Autism Level UP! Where do you fit? How can you learn more? And if you are looking for support then do get in touch – we can help at Imagine Therapy.

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