Cognitive behaviour therapy for people with asperger syndrome
- Type: #article
- Year read:#read2017
- Subject: CBT ASD
- Bibtex: @anderson2006
- Bibliography: Anderson, S. & Morris, J. Cognitive Behaviour Therapy for People with Asperger Syndrome. Behav. Cogn. Psychother. 34, 293–303 (2006).
Key takeaways
- They list several “tips and tricks” to adapt regular CBT for patients with ASD.
Abstract
People with Asperger syndrome (AS) appear to have higher than expected rates of co-morbid psychiatric disorder. The main co-morbid diagnoses are anxiety disorders and depression, but eating disorders, obsessive compulsive disorder, substance abuse and bipolar affective disorder have all been reported. Cognitive Behaviour Therapy (CBT) is used effectively to treat these conditions, so could it be used in people who also have Asperger syndrome? This paper reviews important components and characteristics of cognitive behaviour therapy in relation to its use with people who have Asperger syndrome with reference to the relevant literature and to feedback from people with AS. The use of CBT in people with Asperger syndrome appears promising, but further work is needed to evaluate its effectiveness and to examine which particular aspects of therapy are helpful.
Some suggestions for how to reach a collaborative therapeutic relationship
- Explicit agreements on the purpose of the session
- More directive approach, where the therapist takes the lead
- Adapting to idiosyncratic language regarding symptoms
- Visual materials, tape recording, working together on a computer
Assessment and formulation
- Use visual tools and diagrams to formulate difficulties, development, and maintaining factors
- Behaviourally anchored measures (weight, sleep patterns, activity monitoring) and visual measures of subjective distress are helpful
Structure & goal setting
- The structure inherent in CBT may be extra important for people with AS
- Make sure that the goals are about concrete, reachable things. Get an early win to increase motivation!
Author summary
Some particular CBT techniques and modifications to “conventional” CBT may inform good practice in any psychological work with people with AS. These include:
- Greatly increased use of written and visual material in view of the predominantly visual style of thinking
- Greater emphasis on affective education
- Avoidance of the use of metaphor or abstract concepts in view of the literal, rigid thinking style
- A more directive approach than is usual in CBT, judiciously used when appropriate
- Involvement of a family member or key worker as co-therapist in an attempt to improve generalization of skills.
Paperpile annotations
Page 1: Highlight annotation by Oskar Flygare on December 22nd 2017, 8:03:50 am:
People with Asperger syndrome (AS) appear to have higher than expected rates of co-morbid psychiatric disorder. The main co-morbid diagnoses are anxiety disorders and depression, but eating disorders, obsessive compulsive disorder, substance abuse and bipolar affective disorder have all been reported. Cognitive Behaviour Therapy (CBT) is used effectively to treat these conditions, so could it be used in people who also have Asperger syndrome? This paper reviews important components and characteristics of cognitive behaviour therapy in relation to its use with people who have Asperger syndrome with reference to the relevant literature and to feedback from people with AS. The use of CBT in people with Asperger syndrome appears promising, but further work is needed to evaluate its effectiveness and to examine which particular aspects of therapy are helpful.
Page 2: Highlight annotation by Oskar Flygare on December 22nd 2017, 8:18:03 am:
Asperger syndrome is defined by serious difficulties in reciprocal social interaction, evident in both verbal and non-verbal communication. Difficulties forming and maintaining relationships may be particularly evident in the one-to-one therapeutic relationship
Page 4: Highlight annotation by Oskar Flygare on December 22nd 2017, 8:22:41 am:
Collaborative development of a visually-based diagrammatic formulation of difficulties, their development and maintaining factors may be even more helpful in people with AS, given their preference for more concrete presentations.
Page 4: Highlight annotation by Oskar Flygare on December 22nd 2017, 8:23:11 am:
There are, however, no studies validating the use of general instruments in populations with AS. Informant information, behaviourally anchored measures (weight, sleep patterns, activity monitoring) and visual measures of subjective distress, such as the “emotional thermometer” (discussed later) can be used for baseline information and monitoring.