The overall goals of therapy for adults with Autism Spectrum Disorder are twofold:
- To understand better one’s behavior and how it impacts one’s life.
- To develop the skills that are important for effective functioning.
These two broad goals are achieved when the therapy process provides the structure, guidance, information, and support needed to help one function more effectively, as a person and member of society.
The process of therapy achieves these goals through the following:
Learning About the Person’s Perspective
An essential part of the therapy process is learning about the person’s “worldview” and how that influences his or her way of engaging in society. Mr. B, for example, talks incessantly. It’s hard for him to separate essential from nonessential details. He shifts back and forth from important and interesting ideas to nonessential and unimportant facts. Recognizing that this meandering conversational style turns many people off, enables the therapist to help Mr. B notice when he is “losing” people, and thus develop a more effective way of relating.
Establishing Rapport and Developing Trust
Meaningful relationships are hard to achieve for most adults with Autism Spectrum Disorder, and a feeling of safety and trust in others is often a casualty of this problem. Focusing on the person’s concerns and interests establishes the therapist as a safe, interesting, and helpful supporter, enhancing the person’s motivation to grow and change.
Once rapport and trust are established, a therapist can focus on helping the person organize and improve critical thinking skills, learn new ways of relating to others, and develop better overall coping strategies.
Understanding Emotions and the Needs of Others
Emotions are especially difficult for adults with Autism Spectrum Disorder to analyze, understand and interpret. Typically, they are concrete and literal, and they often lack the analytic skills and flexible strategies needed to comprehend emotional matters. Understanding their own feelings is difficult enough; other people’s feelings are even more challenging. Doing so requires considering another person’s perspective simultaneously with one’s own, a difficult task for an Autism Spectrum Disorder adult.
Ms. A expressed a desire to be married, a seemingly unusual goal for someone who rarely talked to others and had never dated. The therapy process clarified that what she really wanted was companionship and intimacy. Knowing this helped her focus on developing goals that were more attainable and realistic for someone with no dating experience.
This same woman had trouble understanding other people’s perspective. As soon as a man showed interest in her, she developed a strong attraction to him and quickly imagined they were intimately connected. Recognizing this, the therapist was able to point this out and help Ms. A form more realistic ideas of intimacy and better ways of finding companionship.
Understanding the Relationship between Behavior and Consequences
Often, adults with Autism Spectrum Disorder have difficulty understanding the impact of their behavior. Teasing a co-worker for the type of glasses she wears is not, for example, generally accepted behavior. A therapist can explain how acting this way is counterproductive and then introduce more acceptable ways of relating to others.
Often a priority in the therapy process is explaining the relationship between events and one’s behavior and their consequences. The supportive relationship within therapy makes this kind of feedback less threatening and more comprehensible. It allows people in therapy to be more receptive to suggestions of the changes they can make in relating more effectively towards others.
Coping with Everyday Problems
Modifying behavior is a primary goal for many adults who seek therapy. Excessive talking, for example, or interrupting others, arguing, needing to be right, criticizing, and other socially disruptive conduct is not easily corrected. Reinforcing the importance of controlling these behaviors, helping the person to identify when they are occurring, and examining how they can be avoided are important goals of the therapy process. Developing better interpersonal coping strategies are also essential for many.
Many times, the goal of therapy really involves understanding the inappropriateness of one’s behavior, including the assumptions and emotions that form that behavior, and then generating potential solutions. With this process as the framework of ongoing work, and given enough time to accomplish it, the overall goals of therapy are achievable for many adults with Autism Spectrum Disorder.