YANEA - Autism Consultancy Service

Jade Farrington - Counsellor and Therapist - brilliant explanation of CBT. Loved the example given.

We’re often told that CBT isn’t suitable for Autistic people. Is this true?

CBT stands for cognitive behavioural therapy, and it’s a huge umbrella term for dozens of different techniques covering everything from cognitive restructuring to behavioural experiments to exposure and habituation.

The CBT cycle (pictured) is based on the idea that a situation prompts thoughts, behaviours, bodily sensations and emotions. They can all feed into and reinforce one another. For example, if your body is indicating that you're anxious then you may recognise the emotion as anxiety and get more anxious thoughts, which then increase the bodily sensations, etc.

CBT suggests that by changing the thoughts or behaviours, the others also change. This is true in some cases, and CBT can be helpful for many people if used appropriately in relevant situations. The problem is that it frequently gets used wildly inappropriately. It's like trying to use a frying pan for every job in the kitchen - of course it isn't going to work. That doesn't mean the pan is defective because it can't slice an onion or dry the dishes. (And someone isn't defective if none of it works for them either!)

When completing a CBT cycle, it might look something like this:

👉Situation:
• Agreeing to go to places that don't meet my sensory needs, or staying longer than I want to.

👉Thoughts:
• I'm selfish if I express my needs.
• Other people matter more.
• I'll be ruining the day for everyone if I say I want to leave now.
• No one else seems bothered.
• I just need to get over it.
• I've been in noisier and busier places before and I survived.
• Why can't I just act normal?
• It really shouldn't be bothering me that much.
• I used to be fine, I'm just being silly.

👉Emotions:
• Anxious
• Irritable
• On edge
• Frustrated
• Sad

👉Bodily sensations:
• Feel like everything is slowing and I'm starting to shut down
• Headache
• Intense feeling in chest

👉Behaviours:
• Go to the place or stay there when I'm overwhelmed.
• Snap at people because I'm irritable.
• Stop talking, shutdown, or force myself to mask through it.
• Spend the next day alone because it was too much.

CBT would help you to understand that cycle and consider where you could change your thoughts and/or behaviours. As CBT is a really broad umbrella, there are many, many different ways you might try to disrupt the cycle depending on the issue.

Afterwards, the cycle might change to something like:

👉Thoughts:
• My needs are as valid as everyone else's.
• I am disabled and there's nothing wrong with that.
• My needs are different but that doesn't make them wrong.
• I could suggest a different venue or activity, or say thank you but no thank you this time.
• I could go along for a bit if I really want to, but make it clear I will need to leave after an hour.
• My capacity fluctuates so I might be fine and I might not. I'm allowed to leave if I'm not.
• My sensory sensitivities have intensified with perimenopause. It's frustrating but it's the reality and that doesn't make me selfish or bad.
• Expressing my needs is brave, not selfish, and it models allowing others to do the same.

👉Emotions:
• Lower anxiety
• Lower frustration
• Acceptance

👉Bodily sensations:
• Butterflies when I express my needs, otherwise quite neutral.

👉Behaviours:
• Turn down the invitation, set a time boundary, or suggest an alternative activity.
• Take accommodations such as earplugs, stim toys, etc.
• Step outside when I want a break.
• Leave when I've had enough.

CBT gets touted as the gold standard not because it's inherently better than any other therapy, but because it's easy to measure so there’s a lot of research into it. It tends to be short term and follow a set structure for the particular type of CBT being used. Routine outcome measures collect quantitative data. That all means it's easy to complete lots of randomised controlled trials and form an evidence base.

But research shows that the relationship between the client and the therapist is more important for positive outcomes than the particular modality that’s being used.

The attitude and positionality of the practitioner is vital. If CBT (or another modality) is used in a neuroaffirming way with a genuine belief that there's nothing wrong with being Autistic then it can be helpful. The practitioner needs a genuine understanding of Autistic experience, neuronormativity, and ableism. Unfortunately, where this isn’t the case, then many Autistic people report feeling gaslit and harmed.

They may be pushed to reframe things they don’t want to, and told their thoughts are wrong. When I use CBT, it's because the individual isn't happy with the way they're thinking or behaving and wants to change one or both of those things. It’s offered with the question 'Is this thought helpful or unhelpful to me in this situation?' not 'Is this right or wrong?' And the person whose thought it is gets to decide that, no one else.

I most commonly offer CBT to a client when they want to address their internalised ableism because they don't want to think like that and they believe it's leading them to act in ways that cause further harm to themselves. The example cycle is an illustration of this. We can acknowledge the systemic factors and absolutely not blame ourselves for carrying internalised ableism. It's totally inevitable living in this society. (And nothing about CBT should ever be about blaming ourselves if used appropriately.) But we still have a bit of agency, however small, to shift it a little.

♾️ I offer online counselling and rewind trauma therapy to adults aged 18+. Process your past; understand your neurodivergent identity; and create a life that works for you.

What is the DFE thinking! 🤬 I'm sickened by the Gemma Collins videos. Not by her, but by the DFE being so out of touch with the current education crisis to think these videos are apt!

Another great visual from Social Work Tools and Resources - Free; Socialworkerstoolbox.com

Some children hold it together all day at school… then completely fall apart at home.

The after-school meltdowns, tears, anger, silence, defiance, or exhaustion are often not about “bad behaviour”. They can be the release of hours spent masking emotions, coping with sensory overload, trying to fit in, managing anxiety, and pushing themselves beyond their limits.

Many children are praised at school for being “fine” while quietly drowning underneath the surface. Then they come home to the one place where they finally feel safe enough to let it all out.

More adults need to understand this. One small shift in understanding can completely change how we respond to children who are struggling.

Free THE EXHAUSTED CHILD AFTER SCHOOL ICEBERG – UNDERSTANDING HIDDEN SCHOOL STRESS

LIKE the photo and comment "ICEBERG" and we will send you a message with a link to a free PDF of this resource.

Today is the start of Mental Health Awareness Week. We’re shouting loudly that great mental health care isn't just clinical, it's human. It’s the kind voice at the end of the phone when you’re worried about rent and too unwell to work. It’s the adviser who listens actively, rather than waiting for their turn to speak. And it's you reminding friends and loved ones that these contact details can save lives. Please share 💙

For all those children sitting their GCSE'S - I wish you all the luck in the world. 🍀🤞

For all those children who have masked, been broken, worked a thousand times harder in an educational system that doesn't work for them and are still sitting their GCSE'S - you are an absolute inspiration and deserve the world. 🌟💖

For all those children who maybe wanted and are capable of doing GCSE'S, but aren't in school because the school environment doesn't meet their needs, or they haven't been taught in a way that meets their unique needs - I see you. 👀💜 Please please don't think these exams define your abilities and your future. 🙏✨ You shine brighter than anyone and you can be, and do whatever you want to. 🌈🚀 Might just be a different way to get there, and that's ok. 👍😊

From Trauma Informed Parent.... useful information about the difference changing one word can make.

Social Work Tools and Resources - Free; Socialworkerstoolbox.com

Some children do not “act out” - they react to how safe they feel.

A child who clings, avoids, shuts down or seems overly independent is not trying to be difficult. They are showing you what relationships have felt like for them. When a child has not consistently felt safe, understood or reassured, their behaviour adapts to cope.

Some will stay close and worry about being left.
Some will push adults away and hide their feelings.
Some will swing between both, unsure who to trust.

What looks like behaviour is often attachment.

When adults respond with calm, consistency and understanding instead of control or punishment, children slowly learn that relationships can be safe. That is when behaviour begins to change - not before.

If we only focus on the behaviour, we miss the message. If we understand the attachment need underneath, we can actually help.

Free ATTACHMENT STYLES WHEEL POSTER GUIDE

LIKE the photo and comment "ATTACHMENT" and we will send you a message with a link to a free PDF of this resource.

Shared from Dr Joanne - Neurodivergent Educational Psychologist.

I’ve had SO many parents downloading this free guide, this past fortnight. Just reminding you it is there if you need it (link in comments).

LiL Penguin Studios / Autism Happy Place ... awesome as ever. I hate waiting!!

I am blessed beyond words to have my children and being their mum is the biggest privilege of all... My world 🌎 ♥️ xx