Strategies and interventions - counselling
Many autistic people find it useful to go to counselling. Counselling can help you with things like coping strategies, relaxation techniques and relationship issues.
What counselling involves
Counselling involves going to talk with someone at an agreed time and place, usually once a week though it may be more or less often depending on your needs. The sessions usually last from 50 minutes to an hour. What you and the counsellor talk about will depend on what issues you want to address, and on the approaches that the counsellor is trained in.
Confidentiality
The counsellor should not repeat to anyone else anything that you say to them. However, there may be some specific situations where the counsellor has to tell someone else something you’ve said, especially if you're not an adult. You can ask the counsellor what their rules on confidentiality are.
Your first session
When you arrange to meet a counsellor for the first time, ask if you can have time to find out a bit more about them. This will give you a chance to think about whether you want to have more counselling sessions with them. You may or may not be charged for a session like this. Find out more about what to ask on the British Association for Counselling and Psychotherapy (BACP) website.
Not all counsellors have experience of working with autistic people, but if they are willing learn about autism, they may still be a good counsellor for you. You could send them some information about autism, or specifically Asperger syndrome or demand avoidance if that’s relevant to you, or take it along with you to your first session.
When they start to see a counsellor, some people find that they feel worse for a short while. If you have started to have counselling and you feel this way, talk this over with your counsellor.
Finding a counsellor or psychotherapist
There are a number of ways you can get counselling.
Through your GP
You can go to your GP, tell them about your diagnosis and your difficulties (eg anxiety and depression) and how these difficulties affect your daily life. Ask them to refer you to a counsellor. Some may also offer online and telephone counselling.
Through a local organisation
Your employer, school, university or college might be able to arrange counselling for you, and counselling might be provided by local voluntary and charitable organisations. Mind may be able to signpost you to local sources of support.
Arranging it privately
If you can pay for a counsellor yourself, you can contact one directly. Ask them about where, what time of day, how much and how long their counselling sessions would be. Ask if there would be any charges for cancelled appointments and holidays.
Someone can call themselves a counsellor without having any experience or training, so check what experience and qualifications they have, and ask if they are a member of a professional organisation such as the British Association for Counselling and Psychotherapy (BACP).
- Read more advice about finding the right therapist
- Search BACP’s database of counsellors and therapists
- Check our Autism Services Directory for counsellors who have experience of working with autistic people.
Counselling approaches
Counsellors and psychotherapists use a range of approaches. The one your counsellor uses will depend on their training and what you want to get out of the sessions.
Cognitive Behavioural Therapy (CBT)
There is evidence that CBT can reduce the symptoms of anxiety in some autistic people.
Counsellors trained in CBT believe that if a person changes the way that they think about themselves, other people, what has happened in the past, or will happen in the future, then they'll be able to function better in daily life.
Some people may think in a way that makes it harder to cope with everyday situations. These thinking styles are sometimes called cognitive distortions.
- All-or-nothing thinking (eg I must be OK all of the time without exception)
- Polarised thinking (eg people are either my best friend or my worst enemy)
- Fatalistic thinking (eg things will be bad whatever I do)
- Inaccurate attributions (eg my problems are always someone else's fault)
- Discounting of evidence, if it does not confirm beliefs about yourself.
Dougal Julian Hare, 1997
Some people may have more of an innate disposition to this way of thinking, or experiences in the past may have contributed to how they think and feel about things.
A counsellor using CBT can help you to understand how these thoughts do not help you control your moods or your behaviour, but add to the difficulties that you are experiencing. This type of counselling will help you to think about how your thoughts affect your emotions and actions.
Find out more about Cognitive Behavioural Therapy (CBT) on Mind’s website.
Solution-focused brief therapy
Solution-focused brief therapy focuses on solutions for the future and aims to be concise, clear and practical. Veronica Bliss, a counsellor, has written a book and article about this approach and how it may be able to help some autistic people.
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A self-determined future with Asperger syndrome: solution focused approaches, Veronica Bliss 2007
Psychoanalytic approach
Some counsellors take a psychoanalytical approach, which looks at the person’s unconscious and past. This type of therapy tries to increase the client’s awareness of self and influence over relationships. Autistic people may find this approach quite challenging.
Find out about other approaches to counselling and psychotherapy.
If you are a counsellor
Please contact us to be listed in our Autism Services Directory if you are a counsellor with an understanding of, training in, or experience in autism. As part of your entry in the directory, we encourage people to include details of their approaches and their registration with these professional bodies:
- be listed in the British Association for Counselling and Psychotherapy (BACP) register
- be listed in the UK Council for Psychotherapy's register
- be a member of the British Psychological Society’s Division of Counselling Psychology and be registered with the Health and Care Professions Council (HPC) as a Practitioner Psychologist.
Find out more about autism training.
More information
- British Association for Counselling and Psychotherapy (BACP).
- Finding the right therapist
- Find counsellors with experience of working with autistic people in our Autism Services Directory
- Mental health and autism
- Mind - mental health charity
- Samaritans - charity that helps people talk through their concerns, worries and troubles
- CALM - charity for the prevention of male suicide
- Papyrus - charity for the prevention of young suicide
- The guide to good mental health on the autism spectrum, Jeanette Purkis, Emma Goodall and Jane Nugent 2016
Reference
Hare, D.J., (1997) The use of cognitive-behavioural therapy with people with Asperger syndrome. Autism. Vol. 1(2). Pp.215-225