This can be an effective approach for most people, on the spectrum or NT. As a related aside, much of traditional talk therapy techniques have been discarded in favor of short-term, solution-focused approaches. There are some neuroplasticity approaches that don’t even require the client to speak much of the experience or feelings. The past, feelings, and causality take a back seat to change to meet a client’s goals going forward. Motivational interviewing techniques pretty effectively point out client resistance to change in such a way that the insight is client-achieved, not imparted by a therapist. Make no mistake, the Carl Rogers’ qualities of congruence (genuineness), unconditional positive regard, and accurate empathic understanding creates a safe holding space for clients to work in that is crucial. Being a therapist is part science and part art. There is a goodness of fit concept between therapist and client. But research demonstrates that about 50% of change/healing happens as a result of the relationship connection. Humans are, at heart, very relational beings. Emotional dysregulation is the norm with ASD. It takes time, maturity, and courage for someone on the spectrum to work on this. The NT world does not make sense to them - and they are not wrong. One of the gifts of autism is honesty. My son can sometimes boil a complex problem down to a single, accurate insight. AND he’s not shy about expressing it. His delivery is sometimes not pretty but I cannot argue with his insight. As an empath, I can experience a similar sensory overload with other people’s emotions. Emotions are everywhere. They float in rooms of people, they hang like a cloud over some people, they hover in the atmosphere like a collective experience. But emotions are part of our experience of being human, and they allow us to connect with others. They warn us of danger, and they provide strength and courage when needed. As my son gets older, I see more and more of his heart, and I’m grateful for that. He is not often able to tolerate the closeness of strong emotional connections, what we would call “love”. But there are times when I cannot, either. It burns. It’s just too much some days. If I have something to offer in these ESFJ ramblings, it would be some acceptance and patience, I believe. And kindness to ourselves as parents doing a hard thing with no preparation for it. We are just figuring it all out one step at a time. There isn’t one right way to do this. Our kids are struggling under a heavy burden. They live in a world not accepting of them and their unique gifts and challenges.

It creates calm and then helps build new neural pathways to lock this in. My ds’s anxiety was severe so comparable to someone with a trauma history. Different cause but similar brain mechanism.

Kbutton, thank you for your kind words! Miss it here and glad to visit when I can. ❤️

My ds’s primary disabling condition is anxiety. Second to that is the deficient theory of mind that only allows him to see things from his perspective. Take heart, though! My ds has begun having progress in the area of theory of mind, though. I credit my relentless work over years with him (ha!) and, more recently, friendships with two sweet neurotypical girls his age who have helped him to see and feel another person’s point of view because he cares about them and sees them in emotional distress so wants to understand and support. Fabulous! ❤️

Also, if there is a laundry list of concerns, it’s good to start with one that is easier to achieve success with so the kid experiences that success (and so do the parents) which can propel everyone forward another mile.

Agreed with your last paragraph. My ds does very little of what we would choose for him to do (we have mostly given up on most expectations in the face of the mental health challenges), but he wanted to decrease his anxiety so this is what he works on in therapy. It’s a good place to start, both because he chose it and because the rest of life is pretty irrelevant if he is incapacitated by his mood disorders, which has happened and still does at times.

Ahhh, the magic of non directive sand therapy play! A hard sell week after week with parents, though. 😄

I have a similar kid (breakfast example). I can restate a simple, logical fact 1,000 times but he may not accept it. He is better at 19 than he was at 15, though. I took to telling him I had explained this many times and asking him to repeat my explanation. Saved me some breath and mental energy that way. The need to brush his teeth was one of those issues. $1,000 of cavities filled a couple of years ago helped some because his argument had been “But I don’t get cavities”. He still doesn’t always brush his teeth twice a day, though.

Yes! A select ball coach who has done one on one training with ds just “gets” him and how to get the best out of him b-ball wise. He is an intuitive type who genuinely cares about kids. No training or experience with ASD at all - he just likes my kid and appreciates how hard he works at his game even when he is clearly working under a heavy burden due to sensory or anxiety issues.

You’re good. Lol No, counselors are not specifically trained to work with clients with language disorders. That would be specialized training in addition to the typical track Testing is an entirely different area, and this also requires a lot of skill and ability to follow rabbit trails. SLPs also own a corner of the ASD treatment market for good reason. They are an invaluable part of a treatment team. What I found, both professionally and personally, is that treatment is as much an art as a science. What works for one person does not work for another. What worked last year does not work this year, even for the same kid. And, in truth, none of our kids get all of what they need all the time. There’s not enough time, money, or other resources to see to that. We all have to pick and choose based on our personal resources looking at the kid in front of us at the time. In spite of the research and leaps of knowledge in this field, so much is still spitballing. The most helpful professional in 19 years for my son has been the OT he had from age 3-12. His current therapist (counselor) is very effective with him but in large part due to EMDR, which is not an intervention I would have expected to use with him. It is more typically used for trauma treatment. But it is how it worked out for us, by chance or with God or whatever you ascribe it to.

I’ve done plenty of low talk therapies with kids and teens using play, games, art, movement, active play (ball games), etc. A good therapist will meet a client where he is. Not all therapists are trained in or practice play-based therapies, and this one may not be. Finding a good fit in a therapist can be difficult. As a therapist who also has the experience of raising a kid on the spectrum to adulthood, I will say that my parenting experience enriched my skills as a therapist with the ASD population (and their parents) a thousand times over. My personal experience trumps any training or professional experience I’ve had. These kids/teens are complex and need individualized treatment plans. I think the best results are gained from utilizing a variety of different professional disciplines intervening over many years combined with parental interventions on a daily basis. The results are not often obvious or immediate. It is indeed a slow drip.

Yep. Anxiety drives a lot of behaviors and in my ds’s case, the exhaustion produced by constant anxiety caused significant depression. The past couple of years has been a train wreck of mood disorders. I think the transition from late teen to adult is particularly challenging for this population and lasts much longer than typical. Still not sure if my ds will be ready to go away to a small college next fall, which is his plan. One step at a time.

I may have misunderstood, but it was my impression that the ds is on psych meds. Psych meds do have a place in the treatment of mood disorders. I have found that can be a trickier situation to find the right fit for complex kids, and kids on the spectrum are complex, for sure.

Not accurate regarding counselors. They are trained that gaining rapport is the first step of effective counseling.

Good thoughts and ideas. Wishing you the best. This is a long haul marathon, for sure. A therapeutic (therapist-run) social skills group should be small, around 4-6 teens. In my experience, learning happens more effectively in a group setting with in-the-moment peer reactions and therapist guidance. Peers are amazing change agents for any age group. A support group for you would be invaluable. I never found one that worked for my schedule, and I wish I had.

I think you have answered your own question. It is reasonable to stop counseling at this time and look at it in the future. A year or two with teens makes a world of difference. Helpful to me on my own parenting journey with my ASD kid is realizing that he is on his own time table as far as development and I cannot speEd it up, only support him where he is. My ASD kid has been a big family stressor and a big personal stressor for me so I don’t say that lightly.

Resistant teens in counseling is the norm. This therapist has been able to gain rapport with your ds, which is good. However, you are correct that ds needs buy-in to motivate change. IMO, the therapist should not be surprised that ds is presenting only half of the information. That is typical both of teens and also of ASD. I think your gut is correct, that this counseling is ineffective. It may be the therapist is a mismatch or this may be the most ds can gain at this stage. I think social skills groups geared toward teens on the spectrum can be a wonderful resource but they are very difficult to find. As a therapist, I will say that change comes very painfully slow to ASD clients. As a mom of an ASD 19 son, I will add that just in the past 6 months has my ds begun effective counseling, and it is geared toward anxiety reduction and uses EMDR. He is now self- motivated to change due to discomfort and has the ability to implement change.

Yes, both of my teens essentially followed this plan and have transitioned well to the CC. I was their writing/English teacher and used EIW with great results. They combined literature analysis with writing, and they wrote six papers of 700-ish words each per year in addition to class discussion on the novels. For a reluctant literature and writing kid, I loved Windows to the World. Uses short stories for lit analysis and a slow ramp up to writing. IEW experience not necessary. I also like to tell people how I failed to compel one son to do any writing program for very long until his 9th grade year (he was 12 at the time). Our home is still littered with writing programs one quarter of the way done. In spite of mine and his failings in this area, he is a fabulous writer when necessary, and he has done quite well in CC. They summarized salient points in a handwritten spiral notebook for history in high school until they transitioned to CC. I think your plan is fine for a STEM kid.

Oh yes. I could not agree more with this. I have a completely neurotypical kid sandwiched between one with autism and severe anxiety and another with anxiety and physical disabilities. It is too much for him to bear up under sometimes. Everyone here on this thread is doing their very best under difficult circumstances. We go one step at a time with the information we have, and some of it will be throwing things against the wall to see what sticks. Just a shout out to all the special-needs mamas here today. This is hard as hell.

I have also missed significant mental health issues in more than one of my kids because it is impossible to be objective with your own kids. And I am a mental health therapist with many years of experience with kids and teens. You find yourself here now. You know now. You have not been doing nothing so have not been negligent. It is just that the current situation is not adequate to promote safety and mental health. This is a very complex picture you paint with your daughter. It will take time and experimentation to find what works for her. And then she will grow and change and the plan will need to change, as well. Neurologists can manage mental health meds as psychiatrists can and are often much more accessible. Try this route.

At this point, I would call the therapist again and leave a message like this - "My daughter is in a crisis, is refusing to go to school, and I am concerned for her safety." What were you instructed to do by the therapist in case of crisis? In-patient is a mixed bag, but it sounds like she is approaching this. A family doc or pediatrician can miss this call sometimes that a psychiatrist would not miss. If you are in the US, call your insurance company and ask about in-patient coverage so you have the information. Ask what facilities in your area are covered. You can take her to an ER, but that is the least favorable option.

Yes.

Your daughter is in crisis. This has happened gradually. Her current mental health supports are inadequate and her antidepressant dosage is not effective. In your shoes, I would keep her home from school and get help today. The scenario you describe leads me to wonder if your daughter is having suicidal ideation. If she has a current therapist, call that person. If not, find a local mental health crisis hotline. She needs an evaluation for safety. She may not need to be in-patient hospitalized, and there are other options, but I would not wait to act.

One more thought to echo others - it is just fine to ditch formal schoolwork at this age for a time to work on strengthening the relationship, pushing the reset button, exploring options, getting professional feedback, etc. In fact, it is likely best, as digging the rut deeper is not helping anyone. It is reinforcing the negative experience for both of you and taking time and energy from your other kids. Sometimes the best thing you can do is stop and regroup.

Bingo.