I just attended an informative conference put on by the Obsessive Compulsive Foundation of Western Pennsylvania, called Treating OCD in the Autism Community. I am going to share a few pearls of wisdom I took from that conference.
Understanding how your client functions in multiple areas can help you both with the diagnosis, but more importantly, with your treatment approach. People on the Autism Spectrum often struggle in several areas: Communication, Social/Emotional, Sensory/Motor, Executive Functioning, and Relationships with friends and family.
Sometimes, when symptoms are ego dystonic, their struggles are related to the severity of their anxiety disorder. Other times, when symptoms are ego syntonic, their struggles are connected to their ASD. They can also have their symptoms be intertwined between both issues. For example, a client who can’t stand the feeling of stickiness on their hand has to be assessed for whether this is because of a sensory issue (doesn’t feel good but no fear attached to it), a contamination issue (a fear based concern that sticky things will cause germs to be attached to them which will lead to illness), or both (stickiness feels awful and they have a fear of germs causing illness in them). A careful assessment is necessary to know that you are using the appropriate treatment for the symptoms they have. Without this, you may be up against obstacles that prevent exposure therapy from being successful. It can take being very creative to find ways to do exposure therapy while working with and around the ASD symptoms!
Motivation can be a large obstacle with people who have ASD. External rewards can be helpful to motivate them to do exposure therapy and other skill training. Educating parents about the importance of helping their children into uncomfortable places is equally important. Often parents allow their children to engage in behaviors that feel good (video games, watching t.v.) and don’t realize that they can use these behaviors as motivators to do therapy or even basic activities of living.
In terms of medication, SSRI’s are the standard. Although many children with ASD cannot tolerate an SSRI when they are young, they often can tolerate it when they get older and it can be a helpful part of treating anxiety and OCD.
Most importantly, developing a relationship with these clients so that they feel valued and understood will help them to do the uncomfortable work of therapy.
This post is sponsored by nOCD. Dowload this mobile tool for free.