December and January were horrible. FIL died. I had melanoma surgery and met with the surgeon and oncologist alone because DH was with his mom and traveling. CBT work has been great as my kids lost no time during that chaos, but by the end of it, DS needed some reminders from me. DS is getting better about telling me quickly when he encounters a stumbling block. With the CBT, we discuss problem-solving strategies so that DS can help himself when issues arise. We are in a perpetual state of flexibility.
That is a horrible December and January! I am sorry for your loss and about your health issues. ((Hugs))
This is really helpful for me to hear. I think that CBT as you are describing it could work for some kiddos with ASD, but it might need to be tailored a bit, or the therapist might need to be really insightful about people with ASD. The Attwood book I mentioned earlier about depression in individuals with ASD is CBT-based, but he gets really concrete about how a person with ASD might experience emotions (including as bodily sensations). So, it's CBT principles, but it really keeps ASD differences in mind. It brings the CBT within reach. Otherwise, the person with ASD might conclude "I don't have that feeling" or "That won't help me" when really, it just needs a little tweaking. I actually thought the book was very "rational" in a way some less emotive people would find helpful, whether they are on the spectrum or not.
What your son does with a therapist is not completely unlike what my son does with his BCBA, but the BCBA does more hands-on practice and teaching the self-monitoring while doing things as practice. I would guess that what your son and his therapist do in a session or two would need to be repeated in various contexts and with lots of help over quite a bit of time with my son (and probably would be far more steps). I can see something less hands-on and straight CBT working when he's older, potentially. The other thing about the ABA approach is that a BCBA can observe behavior (of all kinds) and draw conclusions. Then those conclusions can inform the approach. So, it requires less self-awareness on the part of the individual receiving the targeted therapy. My son is pretty self-aware, but he doesn't like to really face things head-on sometimes. So, the BCBA can see he's avoiding a task and put in supports that help him not avoid. It kinds of skips over his needing to be completely on board emotionally or cognitively, but it doesn't mean he won't connect the supports and the help with "Oh, the next time I feel like avoiding, I can try this strategy." But, an ABA can use reasoning, talking, goal-setting, etc. if that works. It's almost like a "try before you buy" experience for my son--he comes to a grudging acceptance that these things have been proven to help, lol! I am not sure I'm comparing those methods with all the important nuances, but that's been sort of our experience of late.
The things your son is allowed to do or misses out on for doing the CBT work is very ABA-like also with reinforcers. So, I think maybe CBT and ABA for someone on the spectrum who doesn't have a really high need for support would not be all that different depending who is implementing it and how well they can tailor things for someone on the spectrum.
Thank you for taking the time to type some of that out. I am hoping that even if this is a bit of a rabbit trail, it will be helpful to people reading, and if Katy is able to find a life-coach for her son, this might help her know what things to ask given her son's individual strengths.