Therapeutic Work For Young People With

Communication Difficulties

ByBy

Clare LangtonClare Langton

Communication & Interaction Manager and Communication & Interaction Manager and

Psychotherapist, Curriculum Support Faculty, Psychotherapist, Curriculum Support Faculty,

Priestnall School, StockportPriestnall School, Stockport

1515thth May 2012 May 2012

BackgroundBackground• My role within PriestnallMy role within Priestnall

• Person Centred ApproachPerson Centred Approach

• Difficulties experienced by students on the Difficulties experienced by students on the autistic spectrumautistic spectrum

• Gaining a greater understanding of diagnosis and Gaining a greater understanding of diagnosis and what it means to the young personwhat it means to the young person

• Why counselling / therapeutic intervention?Why counselling / therapeutic intervention?

• Therapeutic relationshipTherapeutic relationship

• Personal observations and experiencesPersonal observations and experiences

• Students own views and thoughtsStudents own views and thoughts

Does Every Child Does Every Child STILLSTILL Matter?Matter?

• Being HealthyBeing Healthy

• Staying SafeStaying Safe

• Enjoying and AchievingEnjoying and Achieving

• Making a Positive ContributionMaking a Positive Contribution

• Economic WellbeingEconomic Wellbeing

My BackgroundMy Background

• I work as a Psychotherapist as part of my I work as a Psychotherapist as part of my role within a mainstream secondary schoolrole within a mainstream secondary school

• As an inclusive school I work with students As an inclusive school I work with students from a large cross-section of our community, from a large cross-section of our community, including young people with autismincluding young people with autism

• My theoretical background is based in Carl My theoretical background is based in Carl Rogers’ Person Centred, Humanistic Rogers’ Person Centred, Humanistic approach first championed in the 1930’s & approach first championed in the 1930’s & 40’s40’s

Humanistic ApproachHumanistic Approach• The Humanistic approach to counselling and The Humanistic approach to counselling and

psychotherapy was borne out of the desire of psychotherapy was borne out of the desire of some practitioners to move away from the some practitioners to move away from the limitations of a more clinical diagnosis, that a limitations of a more clinical diagnosis, that a person is ‘bad’ or ‘ill’ requiring a ‘prescribed’ person is ‘bad’ or ‘ill’ requiring a ‘prescribed’ therapy, but rather allowing them to look at the therapy, but rather allowing them to look at the human being and the meaning of their behaviour human being and the meaning of their behaviour and the nature of healthy growthand the nature of healthy growth

““as material is given by the client it is the as material is given by the client it is the therapists function to help him recognise therapists function to help him recognise the emotions he feels” the emotions he feels”

(Rogers C. Client Centred Therapy .1951)(Rogers C. Client Centred Therapy .1951)

Person Centred ApproachPerson Centred Approach

• The fundamental philosophy underpinning The fundamental philosophy underpinning Rogers’ theory is that all humans are Rogers’ theory is that all humans are basically good and given the right basically good and given the right conditions are motivated to grow and conditions are motivated to grow and reach their full potentialreach their full potential

• Rogers believed that no two humans are Rogers believed that no two humans are the same and personalities are complex the same and personalities are complex

• He believed emphasis should focus on the He believed emphasis should focus on the client’s ability for self-understanding and client’s ability for self-understanding and self-healingself-healing

Autism and PsychotherapyAutism and Psychotherapy

• Counselling students on the autistic spectrum Counselling students on the autistic spectrum presents its own unique set of challengespresents its own unique set of challenges

• Young people on the autistic spectrum may have Young people on the autistic spectrum may have average or above average intelligence but also a average or above average intelligence but also a significant impairment when it comes to social significant impairment when it comes to social understanding and communicationunderstanding and communication

• They may also experience significant impairment They may also experience significant impairment with emotional expression, regulation and with emotional expression, regulation and recognitionrecognition

• They can appear ‘odd’ in their behaviour and They can appear ‘odd’ in their behaviour and sometimes aloof or selfish, preferring their own sometimes aloof or selfish, preferring their own companycompany

Cont…..Cont…..

“ “ We have to be open to knowing We have to be open to knowing that person’s experience from his that person’s experience from his or her perspective” or her perspective” (Jacobson (Jacobson 2003)2003)

• When working with students on the autistic When working with students on the autistic spectrum personal experience has highlighted spectrum personal experience has highlighted that it is not always easy to understand what that it is not always easy to understand what they are thinkingthey are thinking

• Using my own frame of reference and Using my own frame of reference and experience each case is unique to the experience each case is unique to the individualindividual

• Being different and Being different and not understanding not understanding whywhy

• What does he What does he mean?mean?

• Why is he talking Why is he talking to me?to me?

• Why does he want Why does he want to know what I did to know what I did at the weekend it’s at the weekend it’s none of his none of his business?business?

Experiences of young people on Experiences of young people on the autistic spectrumthe autistic spectrum• Comments / behaviour can appear selfish or uncaringComments / behaviour can appear selfish or uncaring

• Can be very attached to important people in their livesCan be very attached to important people in their lives

• Cannot see why they should acknowledge someone who Cannot see why they should acknowledge someone who has no bearing on their life (from their perspective)has no bearing on their life (from their perspective)

• Can be very happy when they please othersCan be very happy when they please others

• Can be very ‘down’ if they disappoint themselves or othersCan be very ‘down’ if they disappoint themselves or others

• Other people’s behaviour, happiness, disappointments can Other people’s behaviour, happiness, disappointments can be a mystery to thembe a mystery to them

• Can be aware they are ‘odd’ or differentCan be aware they are ‘odd’ or different

• Can be unaware they are ‘odd’ or differentCan be unaware they are ‘odd’ or different

• Have very specific areas of skillHave very specific areas of skill

• Love routine and orderLove routine and order

Understanding DiagnosisUnderstanding Diagnosis

There are four common reactions to receiving a There are four common reactions to receiving a diagnosis of ASC (autistic spectrum condition)diagnosis of ASC (autistic spectrum condition)

•Reactive depression (Attwood 2006) – perception Reactive depression (Attwood 2006) – perception that ASC diagnosis means they are defective in that ASC diagnosis means they are defective in some way, a failure, loser, maybe shouldn’t even some way, a failure, loser, maybe shouldn’t even be herebe here

•Escape into imaginationEscape into imagination

•Denial and arrogance – belief that ‘I am always Denial and arrogance – belief that ‘I am always right’ or they are in some way superior to right’ or they are in some way superior to everyone elseeveryone else

•ImitationImitation

What an autistic person What an autistic person experiences within societyexperiences within society

• Anger / frustrationAnger / frustration

• IsolationIsolation

• Anxiety / stressAnxiety / stress

• DepressionDepression

• Being misunderstood Being misunderstood

• Confusion / Confusion / bewildermentbewilderment

• Inability to cope with Inability to cope with unpredictable unpredictable situationssituations

Cont……..Cont……..

The above difficulties are all barriers to The above difficulties are all barriers to communicating and understanding communicating and understanding effectively and further pressures such as:effectively and further pressures such as:

– Duty / expectation from others Duty / expectation from others i.e. ‘I shouldn’t have to tell i.e. ‘I shouldn’t have to tell

you…’you…’– Non verbal body language Non verbal body language – Social etiquette Social etiquette

only serve to make social integration only serve to make social integration even more difficult and confusingeven more difficult and confusing

Working towards Working towards integration….integration….

Why Counselling / Therapeutic Why Counselling / Therapeutic Intervention?Intervention?

• Behavioural interventions have been at the Behavioural interventions have been at the forefront of addressing the deficit in core forefront of addressing the deficit in core behavioural issues for some time with much behavioural issues for some time with much successsuccess

• Young people are better able to manage and Young people are better able to manage and participate in mainstream communitiesparticipate in mainstream communities

• However, emotional issues do not necessarily However, emotional issues do not necessarily receive the same attention and this can lead to receive the same attention and this can lead to anxiety and depression (Jacobson 2003)anxiety and depression (Jacobson 2003)

• With current focus being on behavioural issues, With current focus being on behavioural issues, emotional issues can go unnoticed or emotional issues can go unnoticed or unrecognisedunrecognised

What can Counselling / Therapy What can Counselling / Therapy Offer?Offer?• A new way of thinking; a new approachA new way of thinking; a new approach

• They are in their own world that they understand, trying to They are in their own world that they understand, trying to survive and make sense of a world that is ‘alien’ to themsurvive and make sense of a world that is ‘alien’ to them

• It is important to be able to help them understand / get to It is important to be able to help them understand / get to know this chaotic environment (as they think) through know this chaotic environment (as they think) through supportive, understanding of their experiences and supportive, understanding of their experiences and frustrationsfrustrations

• Support to gain insight into thoughts, feelings, intentions Support to gain insight into thoughts, feelings, intentions of others as well as themselvesof others as well as themselves

• Develop greater maturityDevelop greater maturity

• Explore memories of blame, being misunderstood, bullying Explore memories of blame, being misunderstood, bullying and injustices which continue to ‘interfere’ with daily life and injustices which continue to ‘interfere’ with daily life

Understanding Counselling from an Understanding Counselling from an Autistic PerspectiveAutistic Perspective

““The methods of analysis used in traditional The methods of analysis used in traditional therapy are based on conceptualisation of the therapy are based on conceptualisation of the development of typical children but children with development of typical children but children with ASC perceive and relate to a very different ASC perceive and relate to a very different world” world”

(Attwood 2007)(Attwood 2007)

Often, when working with young people with ASC they Often, when working with young people with ASC they tell me that they received a diagnosis and been taught tell me that they received a diagnosis and been taught lots of coping strategies. However, no-one has ever sat lots of coping strategies. However, no-one has ever sat down with them and asked them what it is like to be down with them and asked them what it is like to be autistic or why they are always so angry... autistic or why they are always so angry...

Starting Point for Counselling / Starting Point for Counselling / TherapyTherapyAn explanation of what autism is and how it can An explanation of what autism is and how it can impact on them as an individual and also their impact on them as an individual and also their impact on others, is a great starting point. It impact on others, is a great starting point. It opens up an avenue for them to explore:opens up an avenue for them to explore:

•What it is like to be themWhat it is like to be them

•Benefits of ASCBenefits of ASC

•Difficulties in having an ASC Difficulties in having an ASC

•How they think and how that differs from How they think and how that differs from othersothers

•Expectation from others that they will get over Expectation from others that they will get over it it

Developing a Counselling / Developing a Counselling / Therapeutic RelationshipTherapeutic Relationship

• To be able to work with ASC in a counselling or To be able to work with ASC in a counselling or therapeutic way you need a thorough therapeutic way you need a thorough understanding of the nature of autism and understanding of the nature of autism and Asperger’s Syndrome.Asperger’s Syndrome.

• Developing a rapport with the young person is Developing a rapport with the young person is essentialessential

• Identifying hobbies or areas of interest is helpfulIdentifying hobbies or areas of interest is helpful

• Have a genuine interest in who they are Have a genuine interest in who they are

• It is important for them to understand you are on It is important for them to understand you are on ‘their team’‘their team’

Accessing this kind of relationship Accessing this kind of relationship leads to…leads to…• Reduced anxietyReduced anxiety

• OptimismOptimism

• Being more relaxedBeing more relaxed

• Realistic appreciation of Realistic appreciation of who they arewho they are

• An ability to An ability to acknowledge strengths acknowledge strengths and weaknessesand weaknesses

• Greater understanding Greater understanding of autism and how it of autism and how it forms who they are – forms who they are – their ‘self’their ‘self’

Cont…Cont…

• Better understanding of how and why Better understanding of how and why coping strategies workcoping strategies work

• Increased awareness and acceptance of Increased awareness and acceptance of who they are and how they ‘fit in’who they are and how they ‘fit in’

• Greater awareness of how their words Greater awareness of how their words and actions can affect how others think and actions can affect how others think and feeland feel

• Can reduce self-doubt and self-criticism, Can reduce self-doubt and self-criticism, which can otherwise lead to depression which can otherwise lead to depression

Cont…Cont…

Much time is spent trying to understand: Much time is spent trying to understand:

•each others perspective on a situationeach others perspective on a situation

•others response to their behaviourothers response to their behaviour

•their response to others behaviourtheir response to others behaviour

•discovering their interests / skills and using discovering their interests / skills and using them to good effectthem to good effect

•their frustrations and angertheir frustrations and anger

•overwhelming feelings and being confusedoverwhelming feelings and being confused

•how to repair broken relationshipshow to repair broken relationships

Student TestimonialsStudent Testimonials

• I cannot believe how I cannot believe how angry I used to be. angry I used to be.

• It is hard to believe It is hard to believe that it was me who that it was me who drew that picture. drew that picture.

• Anger filled my life. Anger filled my life.

• I was always angry I was always angry but could never but could never understand why. understand why.

I used to think in terms of weapons of mass I used to think in terms of weapons of mass destruction to solve my problems. Things make destruction to solve my problems. Things make more sense now.more sense now.

If people laughed at me I would explode and hit out. If people laughed at me I would explode and hit out.

My anger would take over. Now I can put things into My anger would take over. Now I can put things into perspective. It doesn’t mean I agree with what’s perspective. It doesn’t mean I agree with what’s happening but I do understand better what’s going happening but I do understand better what’s going on. on.

My testimonial My testimonial • NEVER A DULL MOMENT!NEVER A DULL MOMENT!

• No two days are the same...No two days are the same...

• I am privileged to work with such amazing, colourful, I am privileged to work with such amazing, colourful, insightful, humorous, interesting young people...insightful, humorous, interesting young people...

• I am constantly in awe of their ability to grow and I am constantly in awe of their ability to grow and adapt in a world that often misunderstands them...adapt in a world that often misunderstands them...

• They encourage change and understanding from They encourage change and understanding from others towards them...others towards them...

• Watching them grow and develop their self-esteem Watching them grow and develop their self-esteem has been one of the most rewarding aspects of my has been one of the most rewarding aspects of my work...work...

• Ultimately, I continue to marvel at what they have Ultimately, I continue to marvel at what they have taught and continue to teach me... taught and continue to teach me...

Further ReadingFurther Reading• The Complete Guide to Asperger’s Syndrome – The Complete Guide to Asperger’s Syndrome –

Tony Attwood, 2007. Jessica Kingsley PublishingTony Attwood, 2007. Jessica Kingsley Publishing

• Aspergergirls, Empowering Females with Aspergergirls, Empowering Females with Asperger Syndrome – Rudy Simone 2010. Jessica Asperger Syndrome – Rudy Simone 2010. Jessica Kingsley PublishingKingsley Publishing

• Counselling People on the Autistic Spectrum, A Counselling People on the Autistic Spectrum, A Practical Manual – Paxton, K and Estay, A 2007. Practical Manual – Paxton, K and Estay, A 2007. Jessica Kingsley PublishingJessica Kingsley Publishing

• Asperger Syndrome & Psychotherapy, Asperger Syndrome & Psychotherapy, Understanding Asperger Perspectives – Paula Understanding Asperger Perspectives – Paula Jacobson 2003. Jessica Kingsley Publishinng Jacobson 2003. Jessica Kingsley Publishinng

Further informationFurther information

Gareth D MorewoodGareth D Morewood Director of Curriculum Support, Priestnall Director of Curriculum Support, Priestnall

SchoolSchool

www.gdmorewood.comwww.gdmorewood.com

Thank you for listening...Thank you for listening...

Clare LangtonClare LangtonCommunication & Interaction Manager Communication & Interaction Manager

and Psychotherapist, and Psychotherapist,

Priestnall School, StockportPriestnall School, Stockport