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Therapists
often rely on their clients to have some measure of insight into their
difficulties, an ability to recognise and name their own emotions and
considerable expressive and receptive language skills. In addition, the
ability to listen to and process information, as well as some ability to
recall and use learned information at the right time between sessions is
often seen as necessary for a good therapy outcome.
These requirements for ‘traditional talking therapies’ have made it
appear to many practitioners that people with cognitive difficulties,
such as those with Asperger’s Syndrome or HFA, would be unable to
benefit from such approaches. The more typical way of addressing
concerns about unusual or unacceptable behaviour was by working through
the carers using a behavioural approach.
Thankfully, some very creative and thoughtful work is now being done to
find ways to help therapists support people with autism to participate
in therapy despite their probable difficulties with some of the above
skills (e.g. Dagnan & Chadwick, 1997; Sinasen, 1992).
This work, along with the work of many others, has helped to show that
successful outcomes can be achieved with people who have cognitive
impairments and can help therapists to think more creatively about how
to support people with autism in therapy.
The majority of therapeutic work with people who have autism seems to be
centred on Cognitive Behaviour Therapy (CBT) which helps people to
recognise how their thoughts and feelings about events influence their
behaviour. Sinasen (1992) and colleagues have also shown how
Psychoanalytic approaches, which help the person to gain insight into
their difficulties, have been helpful to people with cognitive
disabilities, some of whom also have autism. Both of these approaches
are evidence-based and well grounded in theories of how problem
behaviours develop.
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