Self-Help for Adults on the Autism Spectrum

In another blog post for Mental Health Awareness Week award winning JKP author Dr. Lee A. Wilkinson discusses some of the challenges facing adults on the autism spectrum—

The dramatic increase in the prevalence of autism spectrum conditions among children and adolescents and the correspondingly large number of youth transitioning into adulthood has created an urgent need to address the problems faced by many adults on the autism spectrum. Nearly a half million youth with autism will enter adulthood over the next decade and most will continue to require some level of support. In addition, there is a large and diverse group of adults whose autistic traits were not identified in childhood and have not received the appropriate interventions and services. Although autism symptoms may improve with age, co-occurring mental health issues may worsen in adolescence or adulthood. As a result, there are a significant number of adults on the spectrum who are now seeking help to deal with feelings of social isolation, interpersonal difficulties, anxiety, depressed mood, and coping problems. Unfortunately, mental health problems such as anxiety and depression and even the diagnosis of an autism spectrum condition itself often go unrecognized. Although the rate of co-occurring mental health issues for adults on the spectrum is high, accessing services to address these symptoms is frequently difficult and the extent of the problem will only increase as more and more youth transition to adulthood.

Evidence is beginning to emerge for interventions addressing the mental health needs of this growing and underserved group of adults, including cognitive-behavioral therapy (CBT). CBT has direct applicability to adults on the autism spectrum who often have difficulty understanding, managing, and expressing emotions. It has been shown to be effective in changing the way a person thinks about and responds to feelings such as anxiety and depression. With CBT, the individual learns skills to modify thoughts and beliefs through a variety of strategies which improve interaction with others in helpful and appropriate ways, thereby promoting self-regulation and mental health. It is a goal oriented approach and primarily emphasizes here-and-now problems, regardless of one’s past history, traits, or diagnosis. CBT also provides a more structured approach than other types of psychotherapy, relies less on insight and judgment than other models, and focuses on practical problem-solving. Moreover, because individuals learn self-help in treatment they are often able to maintain their improvement after therapy has been completed. Evidence-based CBT holds considerable promise as an effective intervention for improving the quality of life and psychological well-being of adults on the autism spectrum.

Despite the availability of effective psychological treatments for anxiety and depression, a substantial number of adults on the autism spectrum do not seek professional help. Common obstacles to mental health care access include limited availability and affordability of services, confidentiality issues, lack of insurance coverage, frequent delays and long waiting periods, and social stigma. Likewise, many service providers do not have the experience or expertise to work with individuals on the autism spectrum, particularly those with co-occurring mental health issues. Self-help interventions represent an increasingly popular alternative to therapist-delivered psychological therapies, offering the potential of increased access to cost-effective treatment for a range of different mental health issues. They provide an opportunity for the individual to gain some useful insights and begin to work through their problems with limited guidance from a therapist or mental health professional. Research has clearly shown that self-help strategies are effective, practical, and acceptable for many individuals in reducing mental health problems such as mild to moderate anxiety and depression, often alone or with other forms of treatment. Self-help interventions have the potential to play an important role in providing effective treatment to the large proportion of adults on the spectrum who are experiencing mental health issues.

While there is no shortage of books describing the controversies and challenges related to the diagnosis and treatment of autism spectrum conditions, there is a need for a practical resource for adults on the spectrum that promotes self-understanding and directly teaches effective ways of coping with their emotional challenges. Overcoming Anxiety and Depression on the Autism Spectrum: A Self-Help Guide Using CBT presents strategies derived from cognitive-behavioral therapy (CBT), adapted specifically for adults with autism, to help them overcome anxiety and depression, and improve their psychological well-being. The author takes the best of CBT therapeutic techniques to facilitate greater self-understanding, self-advocacy, and better decision-making in life-span activities such as employment and interpersonal relationships. This self-help guide provides evidence-based tools that can be used to learn new ways of thinking, feeling, and doing. It includes questionnaires, forms/worksheets, and exercises to help the reader:

• Evaluate his or her autistic traits and discover their cognitive style.
• Identify and modify the thoughts and beliefs that underlie and maintain the cycles of anxiety, depression, and anger.
• Apply therapeutic techniques such as mindfulness, positive self-talk, guided imagery, and problem solving.
• Accept the past and achieve unconditional self-acceptance.
• Deal effectively with perfectionism and low frustration tolerance.
• Avoid procrastination and learn to maintain positive changes to their progress

Used alone or in combination with therapy, Overcoming Anxiety and Depression on the Autism Spectrum: A Self-Help Guide Using CBT is an essential self-help book for adults across the spectrum looking for ways to understand and cope with their emotional challenges and improve their psychological well-being.

About the Author

Lee A. Wilkinson, PhD, NCSP, CPsychol, AFBPsS is a licensed and nationally certified school psychologist, chartered psychologist, registered psychologist, and certified cognitive-behavioral therapist. He has published widely on the topic of autism spectrum disorders both in the US and internationally. Dr. Wilkinson is author of the award-winning book, A Best Practice Guide to Assessment and Intervention for Autism and Asperger Syndrome in Schools, also published by Jessica Kingsley Publishers and editor of a recent volume in the American Psychological Association (APA) School Psychology Book Series, Autism Spectrum Disorder in Children and Adolescents: Evidence-Based Assessment and Intervention in Schools.