Re: General advise on NHS counceling and CBT provision for AS people

[jlineton]

I have got a referal to a locally based counceling service following amongst other things my AS assessment. I am wondering of people could render some advise.

 

The service in question has CT provison which I understand is helpful to AS people. However, they do not specalise in AS. This is a London based service. I am wondering if there is a more specalist service avaliable to AS suffers and how one goes about accessing it. The service in question has as its primary focus on treating anxiety and depression, which for sure are a part of AS but not the primary concern. IT is true that for all manner of reasons I have been through some very difficult times recently, some but by no means all have been discussed here, but, I am cautious that there is better or more targeted provision before embarking on this. Any other comments especially about experience of similiar services and with CBT would be very welcome!!!!

 

Thanks

 

JRL

[LancsLad]

JRL I have been through in my life various counseling sessions for depression anxiety etc... I was also at one point diagnosed with a personality disorder which I would question and as a result went through a couple of cognative behavioural therapy blocks one of 16 weeks one of 22 as these things are limited. Just over two years ago I had a diagnosis for AS which I am now very comfortable with, I am 46 years of age.

 

Background over this is how I see things. AS is a not a disease it is a developmental condition, as a result there is no cure. I have met a number of adults and children with AS and I would say we are all very different and quite unique in many ways. I tend to view my condition as being made up of a large number of elements and these are like dots scattered all over the autistic spectrum. Whilst there might be a pattern to these dots in some peoples eyes to others they are random. I could spend a lot of time trying to figure out this pattern for myself but personally think that is wasted effort and time, rather I want to get on living my life with what I have got the good and the bad things.

 

I say all this for one reason I do not believe there is nor will there be in the near future a one stop solves all shop to go to for an answer. As a result you can waste a lot of time and effort trying to find something which is not there. My approach would be to prioritorise your issues and work through them in a logical way. Sometimes by getting a grip on one other elements become a bit easier to handle and rise to the surface so we take those on next. I would not underestimate things like depression and anxiety. I would arguee that my clinical depression plays a far larger role in my life than my Asperger autistic traits do for a lot of the time.

 

JRL I think the responsibility for sorting out the order in which you work through things is yours and yours alone. This may be influenced on what services might be available to you in making iformed decisions for yourself but that is all the help I think a GP for example can give you. In relation to Cognative therapies I think you need to be clearly ready to undertake such work, it can be very challenging. I think there are too many people out there who have had sessions prescribed as if they work like some form of clinical drug, if the person is not open to work hard on very important and difficult issues I think this is simply a waste of resources. I know from personal experience this was the case for my first set of sessions, I was not ready for it. The result was youve had a go it did not work and we have spent a lot of money on it, it took some time for me to have further contact with the service.

 

If I have a critism of mental health services in general is they see things very short term. At times you can be fully engaged in all sorts of things and simply do not have the space or time to think. When you don't manage to get everything together you are often left without support and a feeling it was all your fault why couldn't you somehow get more out of these things. Dealing with a diagnosis of AS and the process around it as with all things related to the health of the mind takes time, self reflection, discipline and a lot of faith that things can be better in your life which needs patience and lots of it.

 

JRL sit back and go for what you feel is the right thing for you at the right time. I believe our gut instincts on these things are really important and should drive our actions. i would be very cautious about looking for that 'golden egg' all too often it feels like we have been given 'the emperor's new clothes' and often get left feeling vulnerable and naked.

 

Just a few thoughts and best wishes.

[darkshine]

LancsLad's made some good points.

 

Personally I'd suggest having an appointment and seeing what you think - ask what is involved - see if you like the people - see if it sounds like it could be for you... this is what I would do.

 

My experience has been up and down with the mental health service. I was provided with no support following my dx and so far there are no AS specialised people anywhere near me for anything other than diagnoses - not yet anyway...

[Tally]

JRL, there are very very few mental health professionals who specialise in treating people with ASD. If going private is an option for you, then you might stand more chance of finding one.

 

I've found with counsellors/therapists that it's more important to get one who "clicks" with you than their experience, training or technique.

 

CBT can work well for people with ASD because it doesn't involve talking in-depth about your feelings, which we tend to find difficult to verbalise. There is an element of discussing feelings, but it is possible to benefit from it without doing this in great depth. As well as feelings, it looks at automatic thoughts (these are different to feelings like anxiety and are more statements like, "if I go there, this scary thing might happen") and behaviour (such as avoiding anxiety-making situations). It is possible to improve your feelings by focussing on these things.

 

The best thing to do is make sure your counsellor is aware of your AS from the beginning. If you can, explain how it affects your ability to discuss feelings. One therapist I had, who I had a lot of success with, told me that most people with depression and anxiety also have difficulty verbalising their feelings, so my difficulty was not unusual for her and she was able to adapt things accordingly.

 

Difficult events in life can lead to all sorts of difficult feelings. CBT might not be the best approach if recent events are the cause for the difficulties you're having at the moment. You might need more to just talk through things and be guided a little to find your way through. A good counsellor/therapist should be able to work out the difference between a normal, healthy reaction, and one that has become a mental health issue, and support you the right way. What you might need is someone to talk through everything that's happened, including your recent diagnosis, and help you get your thoughts clear and start planning for the future.