Posted by alexandra_k on October 18, 2013, at 15:09:28
In reply to Re: sorry » alexandra_k, posted by Twinleaf on October 16, 2013, at 10:59:51
The 'New Zealand autism spectrum disorder guideline' of 2008 (couldn't find anything more recent):
> Knowledge and understanding of ASD are crucial for the success of any theraputic encounter.
> Of equal importance is the theoretical orientation of the counsellor or psychologist. Because of the social and communicative aspects of ASD, expert opinion suggests that psychodynamic styles based on insight, introspection and the development of a theraputic alliance are unlikely to be successful (Recommendation 4.3.8). Cognitive behviour therapy (CBT), a therapeutic approach well supported across problem types and many different populations (including the intellectually disabled), may be more promising (Recommendation 4.3.9).
> The more structured format of CBT and practical emphasis on the here-and-now may account for this. CBT is derived from applied behaviour analysis and beahviour therapy, and addressed the role of beliefs about events in the development and maintenance of emotional distress. CBT typically consists of five components:
- psycho-education about the emotional and / or mental health difficulty, and education about CBT itself
- Teaching the person how to control the physical symptoms of the problem (e.g., relaxation training, specific breathing techniques)
- teaching the person how to identify faulty/irrational cognitions (thoughts), and how to change the cognitions into a more appropriate / helpful form (cognitive restructuring)
-assisting the person to practice his/her new coping skills in situations where the problematic emotions/behaviours occur, this may be a graduated process
-developing long-term plans (relapse prevention plans) aimed at helping the person to identify and respond appropriately to early warning signs and triggers.Because of the symptoms of ASD, even experienced cognitive behaviour therapists working with people with ASD need to understand ASD and how the characteristics of the disorder are likely to present in therapy. Advice to cognitive behaviour therapists on adapting their techniques to more appropriately suit people with ASD includes:
- concentrate on well defined and specific difficulties
-attend to and intervene with the core deficits of ASD (communication, social skills, stereotypical and repetitive behaviour) and alter techniques accordingly
-minimise anxiety about the theraputic process by being explicit about roles, times, goals and using techniques like repertory grid
-be flexible about length of sessions and leaving the treatment room
-avoid direct challenges to personal beliefs, as these may be experienced as personal attack; instead, examine the rationale and evidence and collaboratively develop alternative interpretations and beliefs
- use visual imagery
-encourage clients to write down positive things, rather than relying on changing thoughts in their heads
- incorporate specific behavioural techniques where appropriate, such as relaxation strategies, thought stopping or systematic desensitisation (Recommendation 4.3.10)They keep saying they have to view you as a person not a diagnosis (by law, even) but they really don't seem to have any comprehension at all of what on earth that means. I... Don't know what to say.
I have a three page doctor's assessment... I can take it to work and income. Again... I simply don't see how he gets to say a lot of the things he has said. I think a huge part of psychiatry... Especially the public service over here... Is about punishing people who ask for help. If you ask for help you are... Giving them permission to judge you. Example... P-doc said he felt that I laughed 'inappropriately' on occasion in the interview. Stuff like that. He judges I lack social skills... But he doesn't even make any attempt to observe me interact with my peers. Or even with my students.
I do worry that these file notes will prevent my doing med. But... If they do... Then I guess it isn't something I would have wanted to do anyway. I think that is the way to see it. If the profession really is that judgmental... I... Well... I kind of suspect that it is. That it will be.
I realize that I did f*ck up the Otago interview. Her voluntarily saying that I had interviewed well (and I was the second to last person to be interviewed) was that making socially affiliative but untrue gestures that people make (I do understand the white lie aspect of 'of course you don't look fat in that' though I don't particularly understand why people can't simply stick to truth with diversion e.g., 'if you like it then your confidence in it will make you beautiful' or whatever)... But of course... I did well enough to get an interview then I didn't do well enough in the interview to even get waitlisted. So I f*ck*d up the interview significantly. What did I do wrong? I failed to connect to the guy. I thought he was seeking connection on a spiritual level (pastor dude) and he may well have been... But I was reluctant to connect with him... Was true...
That would have been what it was.
At least I know that now. I know that for next time. The answers are important... But probably what they are wanting is that eye contact emotional resonance connection. I can do that. Sure. It isn't like they are extracting particularly personal or intimate information from me...
Why can't people just be honest with me?
I feel that this is a mixed thing indeed. I fear for my self conception.
poster:alexandra_k
thread:1047868
URL: http://www.dr-bob.org/babble/social/20130914/msgs/1052488.html