Many people go to counselling at certain times in their lives and some autistic people also think that it would be useful for them to go to counselling to help them to cope with a particular situation, everyday life, themselves and other people.

The relationship between a counsellor and someone who is going for counselling (often called a client) is not like any other. It usually involves going to talk with someone at an agreed time and place and typically occurs once a week though it may be more often depending on an individuals needs. The sessions usually last from 50 minutes to an hour. Anything said to a counsellor by a client should not be repeated to anyone else. This is called confidentiality and is covered by something called professional ethics. You should ask the counsellor what their rules on confidentiality are as there may be some specific situations where confidentiality can not be maintained, especially if the client is under 18.

What is talked about varies greatly, and is largely dependent on what the client wants to address. It also varies according to the approach that the counsellor is trained in.

This doesn't mean that a counsellor trained in another way of talking to people will not be able to help. It means that there is more evidence to support the view that a counsellor using cognitive and behavioural techniques may be most able to help autistic people to change things.

A lot of people with an autism experience problems at some time in their lives. They may be more vulnerable to experiencing depression and anxiety than other people, especially in late adolescence and early adult life.

These problems can often be seen in the way that a person with autism behaves when they are experiencing difficulties. They may have more difficulty coping with uncertainty, find it hard to control their behaviour and emotions, decrease significantly their daily activities, have problems with alcohol or drugs, etc.

Counsellors trained in cognitive and behavioural therapy believe that if an individual changes the way that they think about themselves and other people (and what has happened in the past, or will happen in the future) then they will be able to function better in daily life.

Like many people, some people with autism may think in a way that hinders their ability to cope with everyday situations. These are called cognitive distortions (and are also seen in people without autism who experience anxiety and depression). There may be very good reasons why this occurs for example, some people may have more of a genetic disposition to having emotional problems, or experiences in the past may have contributed to how they think and feel about things.


Some examples of cognitive distortions:

  • All-or-nothing thinking (eg I must be OK all of the time without exception)
  • Polarised thinking (eg People are either my best friend or my worst enemy)
  • Fatalistic thinking (eg Things will be bad whatever I do)
  • Inaccurate attributions (eg My problems are always someone else's fault)
  • Discounting of evidence - if it does not confirm beliefs about yourself
    (Dougal Julian Hare, 1997) 

The counsellor may address these problems by, for example, talking about how a person can inaccurately attribute their difficulties to other people. What this means is that they will tend to blame other people for their difficulties.

Thinking that something is all someone else's fault (or is all the fault of the person experiencing the difficulty) is an example of all-or-nothing thinking. This way of thinking is not useful because it just assigns fault to someone and doesn't help people to see what they could change about themselves to make things better.

There are a number of approaches which counsellors may use in their work with clients. The Autism Helpline has details of counsellors that are experienced in ASD and use a variety of approaches. Below is information about the approaches most commonly used by these counsellors.

Cognitive Behavioural Therapy
Cognitive behavioural therapy is one type of counselling that can be useful for a person with ASD
Counsellors trained in cognitive behavioural therapy believe that if an individual changes the way that they think about themselves and other people (and what has happened in the past, or will happen in the future) then they will be able to function better in daily life. A cognitive behavioural counsellor may help you to look at how you think in these ways. They may be able to help you to understand how these thoughts do not help you control your moods or your behaviour, but add to the difficulties that you are experiencing. This type of counselling will help you to think about how your thoughts affect your emotions and actions.

The independent charity Research Autism has information about recent research into cognitive behavioural therapy and its effectiveness. Currently 20 research projects have reported positive changes from cognitive behavioural therapy including reduced anxiety, depression and solutions for solving social problems. Further information can be found on their website: www.researchautism.net

Solution Focused Therapy
Another counselling approach is solution focused therapy. This therapy focuses on solutions for the future and aims to be concise, clear and practical. Although there is limited research into this type of counselling with people with ASD, Veronica Bliss, a counsellor has written a book about this approach and how it may be able to help people with Asperger syndrome (in the ‘Books’ section, below). Veronica Bliss also wrote an article in Communication magazine about the same approach.

Eclectic Approach and Integrative Therapy
Counsellors may say they use an eclectic approach. An eclectic counsellor will select from a number of different approaches that are appropriate to the client’s needs. Integrative therapy is another approach to counselling. This means the counsellor can use different models of counselling and psychotherapy and will work with the client to find an approach that works for them.

Humanistic Approach
Counsellors may also use a humanistic approach. This approach encourages the client think about their feelings and take responsibility for their thoughts and actions. A ‘client-centred’ approach is often used and the therapy can be described as ‘holistic’ or looking at the person as a whole.

Person Construct Theory
Some research has shown that a counsellor or psychologist using Personal Construct Theory may be able to help. This approach is also holistic, and focuses on the different ways that the person has developed to explain the world around them.

Person Centered Therapy
Person-centered therapy is where the client is encouraged to communicate any feelings they have. The aim is for the client to move on from negative feelings and develop their personal skills. Ultimately the aim is for the client to feel in power of themselves and to feel that they are able to change.
These types of counsellors talk about feelings more than cognitive behavioural counsellors. Therefore some people who talk more about how they feel rather than how they think may find this approach more useful.

Psychoanalytic Approach
Some counsellors take a psychoanalytical approach. People with ASD may find this approach challenging as it is an approach that looks at the person’s unconscious and past. This type of therapy tries to increase the client’s awareness of self and influence over relationships. These areas are often at the heart of what people with ASD find challenging.

Gestalt Therapy
Gestalt therapy focuses on the client’s experience including feelings, thoughts and actions. Gestalt is a German word which means organised whole. The focus is on analysing behaviour and body language as well as talking about feelings. By going through this process they aim to increase the client’s self-awareness.

The counselling relationship
Whatever the approach the counsellor uses, there is significant research that shows that it is the quality of the relationship between the counsellor and client that makes the biggest difference to positive outcomes in counselling and therapy. Therefore it is important that you feel comfortable with your counsellor and their approach to working with you. There is an excellent article here http://www.counselling-directory.org.uk/counselloradvice10164.html that gives more information on what you should look for when choosing a counsellor.

Ask what awareness and experience the counsellor has in working with your particular difficulty, and if they have experience of autism. It is possible that they will not have worked with someone with an autism diagnosis before, so it is worth explaining what autism is. You could give them the Autism Helpline telephone number so that they could gather further information. Then they will able to understand better what life is like for someone with an ASD and what particular difficulties people with ASD are prone to and why.


How do I find a counsellor?

You can go to your GP, tell them about your diagnosis and your difficulties (eg anxiety and depression) and how these difficulties affect your daily life. Ask them to refer you on to a counsellor who may be able to help. Some counsellors can provide counselling over the telephone or via email. Find counsellors with autism experience.

If you are able to pay for a counsellor yourself then contact the organisations below for details. Prices vary enormously so it is a good idea to ask how much a counsellor charges at the beginning. The counsellor should be accredited by a professional organisation, such as the ones listed below. This is to ensure that they have had a good amount of experience in counselling, so they are more likely to be of use to you. It will also ensure they follow a professional code of ethics.

You may find it helpful to ask the counsellor questions to find out if the approach they use would suit you. Read our guide to questions you can ask a counsellor. 

Alternatively, you could call one of the voluntary counselling agencies in your area. You can get information about these from your local library or online. Sometimes these organisations offer free or low cost counselling. For example Mind is a charity that may have a counselling service in your area.


Useful contacts

British Association for Behavioural and Cognitive Psychotherapies (BABCP)
The BABCP has a register of qualified counsellors with details of the types of problems that they help people with. There is a list on its website: www.babcp.com
Tel: 0161 705 4304

British Association of Counselling and Psychotherapy
The BACP has a list of accredited counsellors and psychotherapists on its website: www.bacp.co.uk
Tel: 01455 883300
Please note: The words 'psychotherapy' and 'counselling' can be used to describe the same thing. It is better to ask a potential counsellor or therapist what the words mean to them to find out if they would be able to offer you a service that you would find useful.

British Psychological Society (BPS)
The BPS has a register of Chartered Psychologists. Some psychologists do counselling as well so you may be able to find a counsellor from the list. You can search for a psychologist on the website: www.bps.org.uk
Tel: 0116 254 9568

Counselling Directory
This website has an online directory of counsellors: www.counselling-directory.org.uk 

Mind
Mind is a mental health charity which offers free or low cost counselling in some areas. Check their website to find your local Mind branch: www.mind.org.uk/help/mind_in_your_area
MIND Information Line: 0300 123 3393, (open 9.00am – 6.00 pm, Monday - Friday)
Email:  info@mind.org.uk
MIND infoline, PO Box 277, Manchester, M60 3XN

UK Council for Psychotherapy (UKCP)
The UKCP has a list of registered psychotherapists on its website: www.ukcp.org.uk
Tel: 020 7014 9955


Further reading

Bliss, Veronica. (2009). Alternative Therapy Communication, Communication, Vol. 43 (3), pp.50

Hare, Dougal. (1997). The use of cognitive-behavioural therapy with people with Asperger Syndrome: a case study. Autism, 1(2), 215-225.

Mental health and Asperger syndrome - available on the NAS website at www.autism.org.uk/15350
or free from the Autism Helpline

Books
(These can be ordered from your local library)

Bliss, Veronica. (2007). A Self-Determined Future With Asperger Syndrome: Solution Focused Approaches.

Howlin, Patricia. (2004). Autism and Asperger syndrome: preparing for adulthood. Routledge.

Lawson, Wendy. (2000). Life behind glass: a personal account of autism spectrum disorder.

Willey, Liane Holliday. (1999). Pretending to be normal: living with Asperger’s syndrome. Jessica Kingsley Publishers.

Willey, Liane Holliday. (2001). Asperger syndrome in the family: redefining normal. Jessica Kingsley Publishers.

Online

www.inlv.demon.nl/irc.asperger/#guidelines
This is a website for people with autism spectrum disorders and provides the opportunity to chat online with others who have a diagnosis of an autistic spectrum disorder

www.mugsy.org/wendy/esteem.htm
This website is constructed by a person with an autism spectrum disorder. It gives hints and tips on how to cope with daily life situations.

www.itsgoodtotalk.org.uk/what-is-therapy/types-of-therapy
The British Association for Counselling and Psychotherapy have information about different therapies at this website.

www.bacp.co.uk/research/resources
The British Association for Counselling & Psychotherapy has information about research into counselling

www.solutionfocused.net 
This is a website which explains about solution focused therapy. It also has information about research that has been carried out about this approach.

www.researchautism.net 
Research Autism has information about cognitive behavioural therapy and research into this approach.

NAS services

If you are interested in having counselling but are having difficulty in either finding a suitable counsellor, talking to your GP about getting a referral or  affording counselling, please contact the Helpline below. We may be able to give you some advice.

The National Autistic Society Autism Helpline
(for relatives, carers, friends and people with autism)
Tel: 0808 800 4104


 

Quick link to this page: www.autism.org.uk/18363