Working with Autistic clients

Allan Turner and Kate Stubbings

Two days of Autism Spectrum training

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Our offer to counsellors working with Autistic Spectrum clients

  General background

We have expanded our Autism Awareness training into two days. The first is "Autism awareness training" and the second is "Autism in the counselling room". The first day will deepen your understanding of Autism, and the second day will be to explore what you say and do in the counselling room. Ideally, you should have already completed the day one training, either now or when we have previously run it. You will only be able to do day two if you have first completed day one or can demonstrate a good understanding of autistic traits. A previous short introduction to the subject will not equip you to understand day two.
In 2013, the DSM-5 replaced "Autistic Disorder", "Asperger's Disorder", and "other pervasive developmental disorders" with the umbrella diagnosis of autism spectrum disorder. The World Health Organisation has headed in the same direction.
We accept that Autism is a neuro-diversity, but not that it is a “disorder". It is hard to find reliable estimates of the prevalence of Autism in the population. Awareness of Autism is certainly rising. Counsellors are becoming increasingly aware of it and likely to encounter it as a presenting problem or as a part of a cluster of presenting issues.
It often causes social communication difficulties in domestic and work environments, and we think this is why it is increasingly coming to the attention of counsellors. We estimate that if a counsellor sees individual clients, Autistic Traits will likely affect about 10% of our clients. They may not have sufficient traits to be diagnosable, but certainly sufficient to cause them, and people around them, social difficulties in communications. If you are a couples counsellor, we think this percentage rises to about 40%.
Failure to recognise this will probably result in both you and your client being disappointed by the counselling experience.


  Day one

The first day of this two-day set will help counsellors understand the difficulty clients with Autistic traits are likely to be encountering. Not understanding the concept of "Theory of Mind" often causes people (including counsellors) to mistakenly think that the client (or not-present partner, child, relative, boss) cannot empathise.
Autistic people often have difficulty with sensory issues with touch, textures, taste, smell, a monotone voice, lack of vocal rhythm. Light, movement, noise, sound-frequency can sometimes be difficult. Proprioception - (the position and movement of one's body in space) - you might call it clumsiness can also be a problem. 


Some autistic people are unaware of the feel of their bodily needs, such as forgetting to eat meals, not sleeping sufficiently, and working to exhaustion, leaving toilet visits until the last minute. A high pain threshold can also be a part of this cluster of difficulties. Hyper and Hypo activity is often encountered.


It is essential to understand that those with Autistic traits have little control of these traits, and it is a little short of cruelty to criticise someone for something they have little or no control over. 


People talk of 'binary thinking'. This is an absolute position where things are either "right or wrong". It often causes people with Autistic spectrum trait to look extremist and moralistic.
Executive Functioning problems can make it difficult for people to keep to time, organise their time and structure their lives. 


When a person with AS traits is too tired, has worked too hard for too long, they are at risk of having a ‘Melt Down’. We will discuss these to help you understand them.


 Day 2

Autistic traits can affect your clients in many ways. Some will present already having had an Autism Diagnosis; others will know very little about Autism. Is the person with autistic traits even present in the counselling room? They may be a partner, spouse, child, ex, boss, employee or many others.


If seeing a couple, the neuro-typical person is likely to give you a comparison. Unfortunately, couples with relationship difficulties sometimes see a counsellor experienced with individuals, but not couples. It might be the person with AS traits, or the partner, who sees a counsellor individually. Whichever it is, it will be vital that the counsellor spots the likelihood of AS traits. Either partner will be very convincing on their own and is likely to believe their partner is the unreasonable one genuinely.

We will discuss how female Autism presents differently about 80% of the time. Females with AS traits often imitate other females (it is how we all learn social behaviour). When young, they appear to be similar to other females, but they will often realise that this is an act by adulthood. This is often referred to as masking.

Most counselling work with Autistic Spectrum clients is demanding and requires the counsellor to think like an AS person. How else can we ever hope to understand them? If you can’t understand your client, you will not make progress. On the first day, we talked about understanding the concept of “Theory of Mind”. As a counsellor, you need to understand this concept. If you are to counsel clients with autistic traits, you will also need to understand the “Theory of the Autistic Mind”. We have to stop simply looking in on the Autistic mind and start looking out onto the neuro-typical world as the AS person sees it.

We will look at when to bring up the subject of autistic traits and when not to!
Frequently, the counsellor finds herself translating between the AS world and the NT world. The more fluently you can speak and think in both languages, the more help you will be.
The days will include screen shares: appropriate video and free additional material. You will be able to see, and talk to, the presenters and other participants throughout the two days. You will be meeting other counsellors who share your thoughts, concerns and doubts.