Preparing for Counselling

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Hi Everyone,

I'm usually a bit of a lurker I admit, and often pick up bits of advice just by reading because to be honest; I have no idea whether I'm doing the right thing a lot of the time.

My 8 year old daughter has enough autistic traits that we think, as does our GP, that she's has an ASD. However, this has never been formally diagnosed.

Lately she's been so angry, particularly after school. Often crying and difficult to communicate with. Things like a human anatomy lesson that they were "teaching wrong", or jokes that she feels are mean. She shows no behaviors at school, and I believe this is because she is afraid of not being seen as "good".

She believes she must always be good. And if she has been naughty, as all children are sometimes, and I correct her she will blame it on everything and anything to justify her action. When she finally accepts she is in the wrong she will hit herself to punish herself for being "bad". I have tried to explain to her that as a child she isn't always going to get it right, that even adults don't get it right all the time, but she doesn't accept that flaw in herself.

She hates to be told that we love her, because she feels it is untrue, and we are therefore lying. I think that is the bit I find hardest to cope with as I don't know what evidence will convince her of our love.

At the advice of our GP we have found a counselor for her to hopefully give her some new tools to cope with the emotions she is experiencing, and to help improve her self-esteem. The first appointment is booked for a week today. I am not sure she is going to be open to this and any advice on how to prepare her for it would be appreciated. I am planning on broaching the subject tomorrow evening for the first time, as then she can be angry with me, but will hopefully get used to the idea over the next week.

Thank you for reading all that, and any advice you can give me.

She does sound consistent to having ASD traits regarding the perfectionism and the rigidity with how things are done. A counselor might do her some good if the individual is experienced in how to deal with it. Are you planning on pursing a diagnosis?

Thanks for the reply.

The counselor is experienced with assisting children with Aspergers and anxiety, and hopefully that will cover her main difficulties.

As for going for a diagnosis - I'm not sure. I know the counselor wouldn't be able to give her one. As we're in the UK she has been referred to the Child and Adolescent Mental Health Service (CAMHS) however there is no guarantee they will even assess her. We could do it privately if we need to, but I am unsure it would provide any advantage to her.

For counseling to work well, trust is important, so whatever you do, don't lie or trick her into going. Don't ask if she wants to go, especially if it is not an option. If the counselor is experienced as you say, he/she will know how to provided information and reassurance to make the process work. Answer any questions they have to the best of your ability, but don't add more that what they ask for... in other words, don't add worries she does not already have.

Provide information that relates to helping her and you both. I usually ask the child if they struggle with anything at home or at school. This helps me to know how resistant they are to therapy and to use their language. I explain that my job is to help them (if they agree they need help) and to help mommies and daddies and teachers to know how to help them better. If they insist they do not need help, I talk about the parent wanting help and ask if they will help me help mom or dad.

Here is a good description of a therapist's job in children's language as well.

http://kidshealth.org/kid/feel_better/p ... tedArticle

Another way is to write a social story about going to therapy.

Here is another good do's/don't for what to tell your child

http://www.wishingwellscounselling.com/ ... -children/

Thanks for you great advice Eureka-C, it was well thought out and very helpful.

I told her this evening and followed your advice. I haven't used the words "counselling" or "therapy" though as I don't want her googling and coming up with misconceptions. Instead I have told her she is going to see a lady who can help her find ways of dealing with her anger and frustration.

I can't say she's very pleased, or even, you know, pleased. And initially she screamed in at a frequency that physically hurt me, before crying great sobbing tears.

However, our discussion was invaluable and I understand a lot more from her perspective. Her biggest fear is that the lady won't be nice, and she doesn't like to meet strangers because she doesn't think they are nice. I explain that the majority of people are nice, and this lady especially. Mim was quite concerned that this lady would be faking her niceness, as she believes most people are faking. When I asked why she said there are people on the news all the time who were faking being nice before they got caught. Mim says you don't know if someone is faking as it's easy to do, and she does it all the time to make sure that her friends still like her.

She then told me the lady may have done "something bad" in the past, and once you do something bad you are bad forever. I tried to explain that everyone does bad things sometimes, even Daddy and me, we don't mean to but we're only human and we make mistakes. It doesn't make us bad forever. Mim didn't quite get this concept as she wants everyone to make the right decisions all the time.

She also told me how she believes she is coping and so doesn't need the lady, or the hated social group at school. That she feels the urge to "attack" when she is angry, but doesn't because she understands that this is inappropriate. I tried to explain that while this is good, it doesn't help her to release her frustration. Unfortunately Mim wasn't sold on this either though as she doesn't feel that there is a way to do this.

On the whole a very enlightening discussion, that went far better than I had imagined, and I am truly grateful for your advice in this. She is going, and although she was calm enough to enjoy some puzzles with us this evening she did, very calmly, tell me she was still angry with me.

I'm neither a parent nor 8 years old, but I would like to add one thing. Explain to your daughter what the expectations from her are during therapy, and what the written and unwritten rules are. This way, it's not going to hit her over the head like a sack of potatoes when she starts the therapy. I had such an experience as a kid, although I was older: 11. (I'm male, which makes a difference in the next paragraph.)

So I started doing therapy, since I had trouble adjusting after making a cross-country move less than a year prior. I was in her office, trying to find out what's allowed and what's now allowed. Crying? Yes. Swearing? Yes. All I could think was: "Whaaaat?! ! This can't be right! There's no way a child would be allowed to swear! There's no way it's OK for an 11-year-old boy to cry in front a stranger! There has GOT TO BE A CATCH!". Needless to say, I never swore or cried, no matter how hard the therapist tried to prod at my feelings, using mental efforts that would now require two shots of vodka and a cigarette afterwards. Therapy degenerated into a battle of wits of sorts, between me and her. Plus, she took my parents' side on things like limiting my food intake, which made her untrustworthy in my mind. (Well, truth be told, I did have a weight problem at the time, but still.)

Many, if not all, child therapists in the US are heavily focused on feelings. (A.k.a. "how did that make you feel?".) To add insult to the injury,, aspies like your daughter often don't know the answers to that question. Perhaps your daughter can rehearse answers and/or memorize emotion words, so she won't be sitting in a therapist's office, and every time she answers their question, he/she will tell her: "no, that's not how you really felt" or "no, that's thinking; what did you feel" over and over, until she tells a blatant lie just to get the person off her back (that is, something she knows the therapist wants to hear, but is nowhere near true).

This is extremely patronizing! Any child who's even a little bit jaded by life will see right through this phrase, and will know something fishy is going on. Questions will arise, with most of them hidden inside the child's mind, such as:
* Who is this lady?
* Why does a full-grown woman want to be on a first-name basis instead of Ms. LastName, like my teacher? (not all therapists do this)
* What if this gets out at school?
* Who is she working for, and what's her goal? (perhaps this questions is beyond an 8-year-old's mental capacity)
* What's the deal with the toys in the office?
* Is this lady a moron, or does she think I am? Of course I can name seven different colors.
* What does she mean with "how did that make me feel"?
Etc, etc, etc. Most importantly, the aforementioned lady is an adult, which means she, bluntly put, "works for the parents". She may be nice to me and have no authority to actively punish me, but her being an adult put her into the "parents and teachers" category, rather than "friends", which went along with the "don't trust anyone over 30" belief I harbored. In my case, my sex worked against me as well, since I (male) felt very uncomfortable talking to a woman about things like becoming interested in girls, erections during gym class, and being embarrassed to adjust my privates in public (through my jeans pockets, that is).

Thank you for your reply Aspie1, and for sharing you're experience of therapy.

I have explained to Mim that her time with the lady is confidential, and that the only time that the lady would tell anyone anything without Mim's permission - including to me or Daddy - would be if she was concerned that Mim was being hurt. I hope this goes some way to assuring Mim that the Counselor is on her side. I have assured her that the time is hers to do what she feels she needs to do, even if that doesn't involve talking to the lady.

I hadn't thought about her asking Mim "How did you feel?" simply because having never experienced therapy myself I am not sure what to expect. Mim can tell people what she felt at a given moment, although she only varies between three emotions when vocalizes them: Happy, annoyed and angry. The Counselor herself is experienced in autism, aspergers and anxiety so I am hopeful she will be able to bridge this gap, but I will explain to Mim that she will be interested in her feelings.

I can understand that I sounded patronizing in text. Please be assured that I wasn't talking down to Mim, or lying to her, only putting it into age-appropriate language. Google truley is as much of a menace as a help at times. I have said that she is qualified to help children who are having difficulties with things like anger.

I am not concerned that Mim will think it odd that she calls this adult my her first name, as this is not unusual in the UK. All adults other than teachers are. And I think the "What's her goal?" question might be a bit beyond Mim's level. Mim is aware that this lady will have toys and a sand-tray in her office (She has informed me she will not be playing with sand as that is for babies. )

The thing that does worry me a bit is the funny question about colours though. Mim doesn't take well to being asked things she thinks are obvious. Do you know why your therapist asked you that?

I'm sorry you don't feel your experience was particularly successful. Do you think this was a clash between you and the therapist due to gender? Simply because you didn't trust adults? Or do you think therapy is generally not successful for those with ASDs?

I'm from the US, which is more formal in this regard, interestingly. Kids and teens generally call all adults Mr./Ms. LastName, even friends' parents. The cut-off line for following this rule fluctuates from 16 to 24. So when another therapist, who I saw later when I was 13, introduced herself to me as FirstName (probably as a misguided way of getting on my level), my BS radar started wailing like a firetruck. (Truth be told, she was no older than 22, but to 13-year-old, that's barely any different than 62, save for a smoother face and a higher voice.) This original therapist, in her late 30's, introduced herself as FirstName LastName, which was formal enough to pass my radar.

I have no idea! Like I said, all I could think was "Is this woman a moron, or does she think I am?" Maybe it was a test of my ability to answer questions. I somehow knew it was in my best interests to keep calm and just answer the damn question, so I named all seven colors like a trooper. But I was probably expected to react a little negatively to a simplistic question like this. Either way, she moved on to more normal questions afterwards.

I think it was all three of these.
(1) I grew up in an authoritarian household, and until 4th grade, went to a private school with uniforms (rare for US schools), very strict discipline, and an accelerated curriculum (that meant basic algebra in 3rd grade, while in most US schools, it doesn't get touched until 6th grade), so I quickly picked up on the message that adults were untrustworthy. The therapist was an adult, so in my mind, she "worked for my parents" and could not be trusted with anything they didn't already know. (My insomnia? Sure! Trouble in school? No way!)
(2) By age 11, I already had topics that I felt uncomfortable discussing with women, especially strangers. Heck, at one point, I was even embarrassed to ask a female teacher if I could use the restroom. Plus, without shared anatomy, even now I think a woman would have trouble understanding the notion of having an erection in gym and why it would be embarrassing. Now, I can fall back on the "We're all adults; get over it!" statement when talking about sex with women, but it's a whole different ball game at when you're only 11. Plus, the US as a whole is more prudish about sex than the UK.
(3) That therapist's methodology was Rogerian. That's the one with the question "how did that make you feel?". And whenever I answered it, she'd say something like "No, that's not how you really felt, try again" or "That was thinking; what did you feel?". Eventually I started lying to her face, only to have her compliment me on my honesty with my feelings. Needless to say, I still have zero faith in therapy of any kind. Plus, with a different medical system in the US, therapy get used as an easy way to extract money from insurance companies.

Well, we went.

Unmitigated disaster would be over stating it - but it wasn't a success.

She doesn't want to talk to her. She doesn't like her - she's too nice. She did speak today, because she felt it was rude to just ignore her. She doesn't want to though. She doesn't want to go in school time because she'll miss lessons, ad she does't want to go outside of school hours as she doesn't want it to take up all of her time. After all, that's why she doesn't do after-school clubs. She thinks the counselor is unhelpful, and that she doesn't need her anyway. Mim wouldn't let me leave the room.

She did like the room though. And would go back if we take fondant for her to play with, as clay and sand is too messy. She doesn't want to draw as that would give the counselor information on her, and if she goes back she doesn't want to talk to her.

I don't know what to think. Do I take her back if she agrees? Or do we muddle on and try to find other ways to help her manage? Although she didn't want to talk, she did. And she talked about how confusing and stupid some of the rules in her school are. How her friends confuse her, and how much she hates when they move the classroom around, or change the routine. As much as I want to help her, if she just wants to go because she like the room it's an expensive thing to do.

I don't know what I was expecting, really. Maybe, that she would go and decide she really likes the lady, and would be happy to talk to her, and draw, and play, and stuff. I think my expectations were too high. I just feel at a dead end.

I am sorry.

I would think it might take more than one visit to see, so her liking the room might be a way to see if she will try again. I honestly do not know what I would do in your place. Did the therapist talk to you in private about any of this? Does she have a specific game plan? Does she say in the end what the goal of the counseling would be -- learning coping skills for anger--venting---???

I guess I would want a kind of road map that included how long the acclimation process should take and all of that.

Reading through this thread, my main thought is that your daughter's levels of social awareness and cognition about her own and other people's thoughts and ability to tell them to you are too high for her to have ASD.

Really?

My impression is that mum is saying daughters social awareness is minimal and inaccurate and her cognition about her own and other people's thoughts is simplistic and full of error.

Either I totally misread the OP's reports, or I have been seriously mislead about Autistic Spectrum Disorders, or there is some other thought behind your analysis. Either way, I don't get it.

Thanks for the reply ASDMommy,

As the evening has gone on Mim has began to ask if she can go back to squish the play-dough and tell the Counselor what it is, so maybe I was worrying too early. No, she hasn't given me a game plan, I think she really wanted to meet Mim first, and go from there. I'm hoping when I email her to set up another session she will give me a bit of feedback on what she thought.

As I said, bybnnyr, this is only something we believe. Mim has no formal diagnosis currently, but this is a working theory. However, I would disagree with you on Mim's awareness of other people's thoughts. She tries to guess what people are thinking, or will do, but often gets this wrong. For instance she will not tell the teachers if someone is mean to her, even if they are physical towards her, as a teacher once believed the naughty child over her and she believes they will always disbelieve her now.

I meant that it is strange to me that an autistic child would attribute so many thoughts to others even if they are inaccurate about what other people are thinking. Children are often inaccurate about what other people are thinking, but the act of thinking about what other people are thinking seems to me not that compatible with ASD. And knowing when it is rude to talk or not talk seems like knowing too much social rules and being able to apply them in real-time. It seems like the OP's daughter has spontaneous social cognition, but is getting things wrong due to possibly other issues like anxiety instead of ASD.

Awareness of social thoughts and the ability to manage them is on a spectrum like all other traits. My son is 8 (going on 9) and there are social things he knows but cannot execute. There are social things he thinks he knows that are wrong. Recently, he has taken to asking me questions on the regular like, "Are you worried?", "Are you panicked" , "Are you "concerned?" That is because he is finally just starting to understand that his radar is way off, and he is seeking outside validation for his guesses. Before that, he was sure he knew and would frequently exclaim his misconceptions without accepting that he could be wrong. Certainty is not necessary more advanced than uncertainty.

The frequency of social related comments just means she is aware that her world is affected by other people. It does not imply a particular skill level. I would think it would be common amongst people with HFA/AS to have that awareness. I don't know about LFA, but I don't think she is thinking that it is LFA.

I think it is really positive that she wants to go back, her complaint is the lady is too nice, and she was able to speak about what bothers her and that she feels confused.

If she tells the lady this stuff, that will let her get to know your daughter and maybe even help her help your daughter find a better way to deal with what she doesn't like and feels confused by!!