Autism-Informed Therapy

What is Autism-Informed Therapy?

Autism-Informed Therapy is simply therapy that takes autistic neurodivergence into account, and adapts to the particular ways autistic people process the world. Given that therapy is a social/interpersonal setting, particular attention should probably be paid to non-typical ways in which an autistic client may process, and interact with, the social world. Different therapeutic approaches have their own assumptions and norms (both explicit and implicit) about interpersonal interaction, which might not be helpful to neurodivergent clients such as autists. (Whether these norms are necessarily even helpful to all neurotypical clients is another question). Therapists also need to make allowances, up to a point, for different preferences with regard to practical communications outside of sessions (setting up or cancelling appointments etc).

Sensory aspects of the therapy setting should also be given consideration, as sensory sensitivity is an issue for many autistic people.

AIT also takes into account the reality, for many adult autistic clients, of some kind of Autistic Compensation (often known as “Masking”), in the sense that they have had to learn to adjust, often in unhealthy ways, to a largely unaccepting world. Some autistic people have developed a kind of "Internalised Autistophobia" equivalent to the Internalised Homophobia experienced by some gay people, because of the stigmatisation and oppression they have experienced.

And, obviously, an autism-informed therapist needs to be accurately informed about autism. At a minimum, they need to be up-to-date as to what is myth ("autistic people are unemotional, unsociable, un-empathic, etc..."), and what is current thinking (stimming serves multiple functions; an autistic meltdown is not the same as a tantrum; the autistic experience is about strengths as well as disabilities, etc...), as well as showing sensitivity to a client's preferences with regard to language and terminology (Asperger's Syndrome, High-Functioning, Person-First or Identity-First, etc...).

And while the actual primary characteristics of autistic neurodivergence are still very much under discussion, an autism-informed practitioner should expect to meet some mix from the following list or similar:

• 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.

A therapist working with an autistic client should also see autism in the broader context of Neurodiversity, a word which can refer to a few different but connected ideas:

• an evolutionary fact (psychological/cognitive diversity is underpinned by neurological diversity, which is in turn underpinned by genetic diversity plus diverse learning environments)
• a paradigm/framework/viewpoint (Autism, ADHD, etc are seen primarily as atypical, “Neurodivergent”, examples of human neurodiversity)
• a minority rights movement/programme (Part of the broader diversity movement, including GSRD, cultural diversity, racial/ethnic diversity, etc)

From the point of view of theories and approaches that therapists will already have some familiarity with, AIT needs to be integrative in the sense of being:

• 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.
  

A framework of Evolutionary Theory can also be helpful, as it assumes that diversity in populations is the norm, not the exception.

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, & outcome-focused
• structured, educational, & 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 etc

I'll return to the above integrative framework in more detail in a later blog...