Please don't quote. I will likely delete.
My son has autism, OCD/anxiety, and ADHD.
As he's hit puberty, it's more difficult to get him to "buy in" to participation in executive skills work, things his therapists suggest for anxiety, etc. He outright tells the therapists that he doesn't need to do x or y. Or, he agrees but when I suggest he practice at home, he is extremely resistant. He "doesn't want to be controlled." He's got so much going on, and I feel scared about his future if we don't address some of this. Well, I'm scared even if we do. But right now I feel like he's spiraling further and further out.
I'm thinking I might get more cooperation if i somehow tied these things (say "changing the channel" on anxiety, or practicing a mindfulness technique, or using techniques to be flexible when things don't go as planned) to earning rewards--probably screen time.
He's very extrinsically rewards oriented "I did x, what do I get?," and it bugs me--but it is already there.
I just can't figure out how to do this. How many things would I select at a time? I feel overwhelmed with what to prioritize. Would I just award a point or whatever for each positive behavior--and would that feed more "situations" to practice it somehow? His behavior therapist wasn't sure how we could structure it. What's the downside, given he's already oriented that way? Alternative ideas to promote, well, cooperation?
This age with him is really, really hard. He's as emotionally dysregulated as he was when he was when he was much younger, and his inflexibility has gotten much worse as he's aged. I didn't see this level of rigidity back then. It's a bad combination.