Autism, mental health and counselling

Autistic adults have a higher prevalence of mental health conditions such as anxiety and depression (Hare, Wood, Wastell & Skirrow, 2015; Tantam, 2000), with Gaus (2007) and Hodge (2017) suggesting that this is often a result of attempts to fit in to society, congruent with findings by Crane, Adams, Harper, Welch and Pellicano (2019). Despite the Department of Health (2014) stating that services that provide counselling and support for mental health should be adapted appropriately, autistic adults report a lack of adequate understanding of autism (Crane et al., 2019) required to meet their needs in these services, and many negative experiences of their needs either not being recognised or misinterpreted in such environments. (Milton & Sims, 2016).

Gates (2019) talks about invalidation trauma, and suggests that autistic people with such experience may have an over-sensitive physiological response to potentially shaming or stigmatising triggers, and also the pain resulting from rejection and hiding parts of oneself due to social oppression. He goes on to say that invalidation by others can be sensed through responses based on assumptions and unmet social expectations, and that removing judgement and stigma from the environment can result in the most significant therapeutic changes, which may be congruent with findings by Radcliffe, Masterson and Martin (2018) indicating a link between feared judgements by therapists perceived as being critical, and failures in therapy.

Feedback from both diagnosed and undiagnosed autistic clients indicates that when they encounter the kind of oppressive experiences that Gates (2019) describes, the ability to verbalise their needs is significantly reduced, but conversely when communication is adapted appropriately, they are more likely to communicate more openly (Beardon, 2017).

Some of the many ways in which I support my autistic clients includes identifying strengths (Beardon, 2017) and resilience, moving away from narratives of deficits and weaknesses, and towards the recognition of the challenges they have had to overcome as a result of living in an environment that is poorly adjusted for their needs (Lai & Szatmari, 2019), to improve self-esteem and develop a healthier sense of self.

The impact of engaging with a service that understands autism is immense, (Department of Health, 2010) congruent with research carried out by Cage, Di Monaco and Newell (2017), and also the views of Gates (2019) Hodge (2017) and Milton and Sims (2016), that the act of engaging a non-oppressive service with an autism positive approach is a process can be transformative in itself. This being congruent also with Rogers’ (1951) view that there is significant therapeutic value when there is genuine acceptance and understanding of the client.


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