Autism and CBT

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I have mental health issue and am an aspie. As I result of this, I've often have this conversation with a so-called mental health professional:

"I think you could benefit for some psychology" says the mental health professional "Usually for people like you, we would offer some CBT."

I'm excited and start grinning. Finally I'm getting some proper treatment, I think, I will be better and be able to live a normal life. "I'll take it!" I say.

"Sorry but we don't offer CBT for autistic individuals. You need an autistic specific service."

I'm disappointed and think about how this is the conversation I have all the time and know what happens next.


I'm going to skip that because the rest of the conversation that happens is irrelevant. However, I had this conversation about to day ago with my key worker. I can't remember how the conversation moved on the topic of CBT but it did.


"CBT doesn't seem to work with an autistic brain," explained my key worker.

"Really?" I asked deeply interested. I've never heard of that before. I thought about how much times I've had it through charities and private healthcare and wondered if it actually worked. I also thought about the previous conversations about not being able to have CBT and how this is probably the reason why I can't. "I've had it before. Why doesn't it work for us?"

"I don't know," she admitted "I guess it's something to do with how your mind is wired. We can offer you DBT though."


So my questions are this
- Has anyone else been denied CBT on the basis that your autistic, especially on the NHS?
- Has anyone else heard anything like this before?
- Does anyone know why we're supposedly "immune" to CBT?

Wait, I don’t understand this. You should be able to find CBT oil at any natural foods store, in the US anyway. It is legal and does not get you high. It does seem to help anxiety and pain. I have heard it works very well in humans and I know for a fact that it works wonders in cats.

Look around on your own.

I thought she was talking about "Cognitive Behavioral Therapy" LOL

The "oil" in question is CBD, not CBT.

CBT stands for cognitive behavioral therapy

CBD stands for cannabidiol, a non-hallucinogenic component of marijuana that is also present in hemp

DBT I believe is short for dialectical behavioral therapy

To the OP, I recommend you embark on a lifelong quest for "what works for you." If you are offered DBT, take it. It's no magic bullet though. Neither is CBT. Neither is anything else. Take whatever you can get, use the part that seems helpful and discard the rest. Just don't expect to get "fixed" by any treatment. The best you can hope for is to get improvement.

Edited to add: If NHS won't give you CBT, you can do it yourself. Get hold of an inexpensive paperback book called "Feeling Good" by David Burns. CBT basically teaches you to rationally look at your perceptions and self-talk and find mental errors and overcome them.

The "denial of service" - yes, I'm caught in that trap myself since being diagnosed a few years ago. The only non-NHS specialist service I can find requires having PIP benefit to pay for the service, and even then is very time-limited. This seems to be common right across the country.

Can CBT work for autistic people?

In my experience, yes it can, but its effectiveness depends upon the counsellor having a good understanding of autism, especially if Alexithymic traits are present. I've been lucky enough to have had CBT with a counsellor who did have that understanding - ironically, on the NHS while I was waiting for my autism assessment. She wasn't trained specifically as a counsellor of autistic people, but had worked with them in some other capacity. Compared to the previous counsellors that I'd seen, the difference was very noticeable - and the counselling far more effective.

But even counselling with a non-specialist has been beneficial to me at times - it all depends on what particular problems you need help with, and how receptive the counsellor is to our sometimes unexpected perspective on things. Even for non-autistic people, some counsellor/patient pairings work very well, and others far less so.

Even more ironically, the "lock out" from services is partly because the NHS recognised the need for specialists, and introduced guidelines highlighting the importance of specific autism training for counsellors. But of course, such counsellors are as rare as hen's teeth, so mental health services follow the guidelines to the letter by saying you need to look somewhere else!

I've had both CBT and CAT (cognitive analytical therapy) on the NHS and I didn't get on with either of them. Both of the therapists may as well have been the same person because they followed the same script, looked similar and their personalities were identical! No deviation at all; they were like robots.

I was treated as though I were simply a cluster of symptoms - not an individual, and I was constantly patronised and made to feel as though I was to blame for the lack of progress. The fact that not everyone responds in the same way to certain types of therapy really needs looking into. CBT is scripted and glosses over the past so if you have deep rooted issues that take time to resolve, you'll be left feeling frustrated. Many autistic people suffer from extreme executive function deficits which CBT therapists do not understand, so they will blame the client and erroneously assume that they are lazy, or in my case, accused me of not wanting to "get better."

Personality issues also affected my time in therapy because it's very important to me to be understood and respected but that didn't happen. The CAT therapist in paticular was worryingly self-absorbed and would often talk about herself whilst using subtle put downs that made me feel even more useless. She was also the one who told me that the NHS doesn't provide autism specific therapy.

There needs to be more choices for everyone who is experiencing mental health issues, but unfortunately CBT is all that's offered because it's cheap and quick.

I have found that CAT therapy-of the four-legged variety-works well for me!

I think a CBT can work once the way of neurotypical thinking, feeling and behaviour is explained and for this the reasons for adaptions are clear. But I'm afraid they won't explain this because they don't even know that it's a problem to you then.

But I don't know any CBT and the real content of a CBT. May be some people here can talk a bit about their experiences.

_________________
I am as I am. Life has to be an adventure!

I find CBT works well for distorted thoughts that are associated with social anxiety, as well as systematic desensitization exposure therapy which may even work for sensory processing issues of autism to some degree? Socially anxious thoughts are usually filled with cognitive distortions like fortune telling/mind reading, negative filter, catastrophizing etc.

Acknowledging the positives and neutrals (important for depression), and help to prevent jumping to conclusions by being mindful of the possible neutral, positive, and negative explanations or outcomes of a situation you are worrying about that you don't fully know the details or of a situation that you are anxious about in the near future that hasn't happened yet can be helpful if you are suffering from depression. For example, a friend has seemingly been ignoring you today. Negative possible explanation is that they don't like you. Neutral possible explanation is that they are busy with something that doesn't involve you whatsoever. Positive possible explanation is that they are planning a surprise party for you. In any given situation, at least 2 of the 3 (positive, neutral, negative) possible explanations will make sense, but when we are anxious or depressed, we only tend to think of the negative possible explanation for an event.

What I find CBT to be of limited use for is if your life or situation you are going through actually does suck (being seriously ill or being abused for example) and is not just a distortion.

I prefer to use some combination of skills from CBT, DBT, and ACT(acceptance and commitment based therapy), mostly CBT and ACT though. None of them address my executive functioning deficits with autism, nor my ability to detect sarcasm, or poor social skills. They are really limited in how they can help the core symptoms of autism, but more useful to treat co-morbid conditions that come with autism.