CBT for Adult Asperger Syndrome (book)

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By Valerie L. Gaus.

I bought it a while ago but am just starting to read it. I haven't gotten very far so she hasn't started talking about the CBT methodology yet, but two chapters in and I'm impressed with her level of understanding of AS and issues we face (this was obviously written before DSM-V).

So, has anyone else read this book and can you tell me if I should prepare to get disappointed in further chapters? I have high hopes for this book. I'm about to start a new study course so I won't be able to read it very quickly, but if it's worth it, I'll push through as fast as I can. And perhaps I will share some of the interesting insights if people are interested?


I'll give you an example of her good understanding of AS. I know a lot of us have been to psychologists or psychiatrists who have insisted we have social phobia and won't even consider autism. The author describes what we all already knew:

"The adults I have treated with AS rarely meet criteria for social phobia ... some measure of fear about social encounters is arguably reasonable ... It is not excessive or unreasonable for someone to fear social situations if the individual is not skilled enough to handle them. Most of the adults who present for therapy with this problem are painfully aware of their lack of skill and have learned avoidance as an adaptive strategy. These individuals are more likely to be depressed ... but less likely than their gregarious counterparts to offend people or have repeated conflicts and unpleasant encounters because of social mistakes. A social phobia diagnosis can be made along with AS only when the anxiety is out of proportion to the skill deficit."


Note: This book is written for practitioners and others who would be utilising the information, not for the layperson or people with AS. I'm reading it because I have also studied psychology and know a bit about CBT already, so I'm wondering if it's possible to "CBT myself", as I was unimpressed with standard CBT for use on my issues. I probably wouldn't recommend the book to people with no knowledge of psychotherapy etc. as it has a fair amount of jargon.

hey i too enjoy the study of psychology if you don't mind me asking how was the cbt like you already did as i was told be a cbt therapist that it won't work well for me be a cbt therapist not too long before i was diagnosed with asd i don't know if it is my outlook on life or or her agreement with my suspected asd at the time that made her say that also how is the book different from standard cbt

I read a bit of the book online through the Amazon site. It looks well researched and may prove helpful. She also has another practical approach book for Aspies and others with ASD called 'Living on the Spectrum' - which a lot of people have found helpful (or at least taken the time to write glowing reviews)

I think you are underestimating the capacity of many of us to understand psychological concepts and overestimating the complexity of CBT. I have standard CBT text book in my bookshelf published by 2 MDs (with a psychiatry background) and an author with a clinical PhD. CBT can essentially be distilled down to using a few standard techniques (that varies depending on the educational level of the client) and ultimately utilises the power of cognitive self-adjustment in order to correct cognitive errors in a person's thought processes that leads down a slippery slope to depression or anxiety. What CBT does not do is cure people of AS.

This is what I have done over the years long before I even knew about CBT. Distraction techniques, mindfulness, Exposure and Response Prevention and a little bit of old fashioned flooding was how I fixed some of the major issues. I needed a psych for the rest and I'm still hopeless in social situations but that doesn't bother me because I don't want to be in them anyway and have no need to be. That's not avoidance. I'm also scared of jumping off the Grand Canyon without a parachute but as I have no desire to do that either, is that avoidance or common sense?

I recommend you also look into DBT (Dialectical Behavioural Therapy) as well as Schematherapy. All fun stuff

Yes, I know, I was going to actually change the way I worded it. I did change it from "wouldn't recommend" to "probably wouldn't recommend". What I mean is that I WOULD recommend it to people who are already interested in the field (if it continues at the current standard), and wouldn't go out of my way to recommend it to others. That doesn't mean that I don't think they could understand it, but it is written for people who already work in the field, so the layperson would have to do a bit of extra research (or make inferences/assumptions) to understand some of the jargon.

Like I said, I haven't gotten to the CBT part yet. The jargon I have encountered so far is simply "psychologist/therapist" jargon, things I picked up at uni that I might not have heard about otherwise. The target audience is the therapist, not the client, so that was really all I meant but I worded it poorly.

I had a little trouble following your post so I hope I'm answering your question properly. When I underwent CBT therapy (as the client), I found myself struggling with the "what were you feeling?" part of it. I'd always answer with something that wasn't a feeling, like "I felt that I didn't know what to say", and it was a real struggle to come up with anything other that "I felt frustrated". It seemed to me that CBT was designed for people who had underlying beliefs about themselves that were untrue, whereas most of mine were quite realistic, as I think they would be for many people with AS (as opposed to something like social phobia).

This book is suggesting that there is a different way to go about CBT with AS clients, so I'm super curious to find out what that is, and if it might work on myself.

Oh, wow, "Living Well on the Spectrum", I actually have that (unread) book as well. Didn't realise it was the same author. Gosh I really need to make more time for reading.

Just because you have AS doesn't make you immune to all the other issues CBT, DBT and Schematherapy address. These forms of therapy are hugely beneficial to everyone because there isn't an adult human alive who made it without a schema of some sort or another. Read on MacDuff.

hey thanks sorry i just noticed the mistakes in my post someone was talking to me as i typed that

yes what you said was a bit like how i felt and i agree with you about cbt

ImAnAspie you'd be surprised a lot of people with asd online haven't had a great time with cbt maybe its just inexperience of the therapists working with asd clients

What is an unrealistic thought differs for someone with ASD from someone without ASD.

DBT may or may not benefit someone on the spectrum. It was created by Marsha Lineham, who has Borderline Personality Disorder, and wanted to help other people recover from BPD, people who have chaotic lives, are very often suicidal, and self harm etc.

It's very very wordy, and because it's hard to pick up, you're recommended to do everything twice, otherwise it generally doesn't work.

I moderate a support site for people with personality disorders, and anybody who did DBT for 6 months, didn't gain anything, and anybody who did the 6 months repeated, gained at least something from it. The group proved to be more useful than individual appointment, because you'd get feedback from several people, different opinions and such.

DBT is essentially CBT + mindfulness, and a few other things chucked in.

CBT is probably more appropriate and less stressful and more manageable for someone on the spectrum, than say DBT. There's no saying that DBT can't do wonders for someone on the spectrum, but it's very tough going. It's all about diary cards, labeling emotions, etc.
I have BPD so I did do a year of DBT - twice a week it was. Once with a group, once with my individual therapist. I didn't take much from it, because I of course am now diagnosed with ADHD and ASD, so there's that to take into account as well.
It did however help me to be more calming towards friendships. I slip up sometimes, getting into arguments with friends, as we all do, but it helps me think before I speak when I can remember to use the skills learned, and I don't get into a crisis as much any more.

CBT is great though. I would recommend that. It has the appropriate skills for someone on the spectrum.

If any of you are in the UK, see if you can get CBT from the NHS (go to your GP, get referred for some, the GP may already have a CBT councelling group linked to the doctors surgery, rather than getting referred to CMHT).

For countries who don't have free health care, if you have the money to spend on a CBT course, I would give it a try, and if not, look this book up that the OP has spoken of. It certainly seems interesting and obviously appeals more to those on the spectrum.

TL;DR - DBT probably isn't the "go-to" for someone on the spectrum, but CBT tweeked for people on the spectrum, should help a lot.

Thanks for the information on this book and the excerpt, you have persuaded me to check it out once I have finished my other autism books I have had a massive downer on CBT for years due to my experience of it and being told by the therapist that it isn't suitable for me, but I may look at the CBT tailored for ASD and see if it makes any more sense to me. I would be interested to hear your overall view of the book once you have had chance to finish it.