While autism is not a mental health condition, a high percentage of autistic people also experience mental health challenges such as anxiety and depression.
Research conducted by the National Autistic Society and Mind in 2020, found that 94% of autistic adults surveyed experienced anxiety, with more than half saying it affected their ability to get on with life, and 83% saying they experienced depression. In addition, the research also showed that eight times as many autistic people reported feeling lonely compared to the general population.
Finding effective mental health support and treatment is really important, but which therapies are suited to autistic people and how do you choose?
Some examples of evidence-based talking therapies that can be effective are Cognitive Behaviour Therapy (CBT), Dialectical Behavioural Therapy (DBT), and psychoeducation.
CBT aims to break down unhelpful patterns of behaviour and negative thought processes, and combines cognitive therapy (examining what you think) and behavioural therapy (examining what you do.) DBT is derived from CBT and is adapted for patients who feel emotions intensely, aiming to help them process difficult feelings and make positive changes. Psychoeducation is a practical approach that empowers people after diagnosis, helping them to develop strategies suitable to their individual strengths and interests.
It’s important to acknowledge that every autistic person is unique, and any type of therapy might need adaptations to meet your personal needs – whether those be around communication, sensory sensitivities, absorbing new information, and even self-expression. It is equally important that your therapist understands neurodivergence well and is able to be sensitive to your feelings, experiences, and preferences. This level of understanding is essential for therapy to be truly effective.
Considerations for choosing a talking therapy
It’s important to make sure any therapist you work with takes an individualized approach tailored to your unique needs. That means they are open to making adjustments to the therapy structure and content, and are willing to take the time to understand you and take into consideration your preferences, needs, and experiences.
Examples of accommodations you might ask for include sensory adjustments in the therapy room (such as dimming the lights or making sure the space is quiet), attending appointments by video if travel is difficult for you, having sessions at a particular time of day that works with your energy levels, and even communicating in alternative ways like writing, audio, or drawing. There is no set type of adjustment – just think about what would make a session work better for you.
Don’t be afraid to discuss these needs with a potential therapist up front, and if you find communication tricky, consider writing down your needs and any questions you want answered, or asking an advocate to support your initial communication.
Taking an individualised approach will make it easier for you to truly engage in the therapy process and fosters a strong therapeutic relationship, which is particularly important when discussing anything that might feel challenging.
When deciding on a talking therapy, consider the following factors:
– Does it align with what you want to get out of the sessions?
– Can it work around your sensory needs?
– Is it compatible with your preferred way of communicating and absorbing new information?
– Does the therapist seem like someone you can trust and work collaboratively with?
How to decide what’s right for you
When deciding which therapy to try, it is a good idea to do some research and gather information on different providers and their specific expertise. For example, do they have previous experience working with or supporting autistic people? You can also look for recommendations from trusted sources such as other autistic people you know, neurodevelopmental specialists, or autism support organizations.
Once you find a therapy you would like to try, consider requesting an initial consultation to discuss their approach and compatibility. If you have any specific needs (such as sensory or communication needs), don’t be afraid to explain what you need and why, and ask for those needs to be met at the initial meeting. It might be a good indication of whether that particular provider will be open to making accommodations for you if you were to commit to further sessions with them.
How to access talking therapy
You can seek therapy on the NHS by asking your GP for a referral, or using the NHS service Improving Access to Psychological Therapies (IAPT) if you are based in England. IAPT allows you to be referred by a GP or to self-refer directly without going through a GP. Alternatively, you can look for therapy privately by researching local providers. In this instance, the following links might provide a good starting point:
• Autism Services Directory – National Autistic Society
• How to find therapy or counselling – Mind
• Therapist Directory – British Association for Counselling and Psychotherapy
• Advocacy in mental health – Mind
Once you start therapy
In order to get the best out of therapy, it’s important to maintain open communication with your therapist and feel comfortable to express your preferences and needs, set and agree clear goals for your sessions, and provide regular feedback on how things are going.
A good therapist will monitor your progress and regularly evaluate whether the therapy is proving effective. They should also make any additional adjustments you might need – such as those mentioned earlier – as you go along. Talking therapy is a process and it’s essential you are able to collaborate and work together with your therapist, so you get the best out of your treatment. If for any reason you decide it isn’t working for you, don’t be afraid to raise your concerns and ask your therapist to discuss alternative therapies or approaches.
Key take aways:
- Every autistic person is unique so therapy will need an individualized approach
- Where necessary, ask for accommodations to meet your needs (eg sensory, communication, processing new information etc)
- Don’t be afraid to request an initial consultation to convey your needs and ask any questions you might have
- Once you start therapy, maintaining trust and open communication with your therapist is really important
- If something isn’t working for you, don’t be afraid to raise your concerns.
