Counselling

Some people with an autism spectrum disorder think that it would be useful for them to go to counselling to help them to cope with everyday life, themselves and other people.

The relationship between a counsellor and someone who is going for counselling (called a client) is not like any other. It usually involves going to talk with someone at an agreed time and place once a week. The sessions can last up to an hour but can be for a shorter period if needed. Also, anything said to a counsellor by a client should not be repeated by them to anyone else. This is called the rule of confidentiality. You should ask the counsellor what their rules on confidentiality are.

What you talk about with your counsellor can vary greatly according to the 'approach' that the counsellor is trained in. The type of counselling found to be most useful for a person with an autism spectrum disorder is the cognitive and behavioural approach.

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

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

These problems can become evident through changes in the way that a person with an autism spectrum disorder behaves. They may have more difficulty coping with uncertainty, find it hard to control their behaviour and emotions, significantly reduce their daily activities, have problems with alcohol or drugs, etc.

Counsellors trained in Cognitive and Behavioural counselling believe that if an individual changes the way that they think about themselves and other people (and about past or future events) then they will be able to function better in daily life.

People with autism spectrum disorders have more of a tendency to think in a way that hinders their ability to cope with everyday situations. These are called cognitive distortions and are also seen in people experiencing anxiety and depression who don't have an autism spectrum disorder. There may be very good reasons why this occurs. Perhaps a person might have a greater genetic disposition towards emotional problems, or have past experiences that contribute to the way they think and feel about things.


Below are some examples of cognitive distortions:

• All-or-nothing thinking (e.g. I must be OK all of the time without exception)
• Polarised thinking (e.g. People are either my best friend or my worst enemy)
• Fatalistic thinking (e.g. Things will be bad whatever I do)
• Inaccurate Attributions (e.g. My problems are always someone else's fault)
• Discounting of evidence  (e.g. if it disconfirms your beliefs about yourself)

(Dougal Julian Hare, 1997)

Taking one of the above examples, a counsellor may talk about how a person can inaccurately attribute their difficulties to other people. In other words, they will tend to blame other people for their difficulties.

However, this is not a useful way to think because if it was true that other people were to blame for an individual's difficulty in coping, then what would be the use of the person with the difficulty talking to a counsellor? If it were the fault of someone else, then it would make sense for the person at fault to be in counselling in order to change their thoughts and behaviour, and not the person experiencing the difficulty.

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

A Cognitive Behavioural counsellor will look at the ways you tend to think and help you to understand how these thoughts do not help you to control your moods or your behaviour, but add to the difficulties that you are experiencing. This type of counselling helps you to start looking at the way your thoughts affect your emotions and actions.

Other ways of counselling may also help, depending on your personality and the nature of your difficulty. Some research has shown that a counsellor or psychologist using Personal Construct Theory may be able to assist. Alternatively, some people may prefer to see a Person Centred counsellor. These types of counsellors talk about feelings more than Cognitive Behavioural Counsellors. Therefore, people who talk more about how they feel rather than how they think may find this approach useful.

Whatever approach the counsellor uses, it is worth asking what awareness and experience the counsellor has in working with your particular difficulty, and if they know what an autism spectrum disorder is. There is a high possibility that they will not have worked with someone with this diagnosis before, so it is worth explaining it to them. You could also give them The National Autistic Society's Information Centre telephone number (listed below) so that they can get further information. In this way they will be better able to understand what life is like for a person with an autism spectrum disorder and why they are prone to particular difficulties.

How do I find a counsellor?

Go to your GP, tell them about your diagnosis and your difficulties (e.g. anxieties and depression) and how these difficulties affect your daily life. Ask him to refer you on to a counsellor who may be able to help.

Alternatively, if you are able to pay for a counsellor yourself then contact the organisations below for details. Prices range enormously so it's a good idea to ask how much the counsellor charges at the beginning. The counsellor should be accredited by a professional organisation, such as the ones listed below. This indicates that they have had a good amount of experience in counselling.

Finally, you could try calling one of the voluntary counselling agencies in your area. Organisations such as MIND (see contact details below) offer free or low-cost counselling. You can get information about this and other voluntary agencies from your local library.

MIND (National Association for Mental Health)
Granta House
15-19 Broadway
London E15 4BQ

MIND information line: 0845 766 0163 (open 9am-5 pm, Monday-Friday)

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.
Tel: 01254 875277
www.babcp.com - There is a list of counsellors on this website.

British Psychological Society (BPS)
Has a register of Chartered Psychologists. Some psychologists do counselling too so you may be able to get some help by looking at their list.
Tel: 0116 254 9568
www.BPS.org.uk - There is a list of psychologists on this website.

UK Council for Psychotherapy (UKCP)
Has a list of registered psychotherapists which can be requested by e-mail or post.
Tel:  020 7014 9955
www.ukcp.org.uk

The British Association of Counselling and Psychotherapy
Has a list of accredited counsellors and psychotherapists.
Tel: 01788 550899
www.bac.co.uk - There is a list of counsellors on this website.

Please Note: The words 'psychotherapy' and 'counselling' tend to be used to describe the same thing. It is better to ask a potential counsellor or therapist what the words mean to them to ascertain if they would be able to offer you a service that you would find useful.

Further Reading and advice

Mental Health and Asperger Syndrome (Information Sheet)
Available from the NAS Information Centre or the NAS Autism Helpline.

Books

(These can be ordered from your local library, your local bookstore or from the NAS)

Howlin, P. (1997). Autism: Preparing for Adulthood. London: Routledge (ISBN: 0 415115 32 9)

Lawson, W. (1998). Life behind glass. London: Jessica Kingsley Publishers (ISBN: 1 85302 9114)

Willey, L. H. (2001). Asperger Syndrome in the Family Redefining normal. London: Jessica Kingsley Publishers (ISBN: 1 85302 873 8)

Willey, L. H. (1999). Pretending to be Normal Living with Asperger Syndrome. London: Jessica Kingsley Publishers (ISBN: 1 853027 49 9)

On the Internet

http://www.inlv.demon.nl/irc.asperger/#guidelines
A website for people with autism spectrum disorders that provides the opportunity to chat online with other people who have a diagnosis.

http://www.shifth.mistral.co.uk/autism/marc2.htm
http://www.mugsy.org/wendy/esteem.htm
Two websites constructed by people with an autism spectrum disorder. They give hints and tips on how to cope with daily life situations.

NAS services

If you are interested in having counselling but are experiencing difficulty in finding a suitable counsellor, affording a counselling bill or talking to your GP about a referral, please contact The National Autistic Society's Autism Helpline (for relatives, carers, friends and people with autism spectrum disorders) on 0845 070 4004 or email autismhelpline@nas.org.uk

If you know a professional who would like information on autism spectrum disorders, ask them to contact The National Autistic Society's  Information Centre (services for professionals) on 0845 070 4004, or email nas@nas.org.uk

If you require further information please contact the
NAS Autism Helpline
Tel: 0845 070 4004
autismhelpline@nas.org.uk

Last updated: March 2008
© The National Autistic Society 2008
The National Autistic Society is the UKs leading charity for people affected by autism

Related resources

• Mental health and Asperger syndrome