For Mumble and Special talent 123

[Karen A]

Hi Mumble and Special talent.

This is my rather long winded attempt to answer your question....if you or anyone else has the will to spend Sunday afternoon reading it.

It is all personal opinion.I do not pretend to hold any qualifications in this or any other area.

 

Can you let me know when you have drafted out my bit please the response too.

 

' What about people with an ASD with a complex mental disorder like me?' I have learn't this year that i realising, that being in the LD psych team isn't really to do with treating the mental health side, to he honest mental health needs to be sorted. I get the feeling they are trying to treat my disability when i don't want it treated i want treated my mental illness and being DBT may not work for some- but surely they have to train in both sides, because why would the LD team diagnose me along side with a complex mental disorder.

 

I see there is CAMHS and yeah its a ' Child Adolescence Mental Health Service', which i nearly had the ASD advisor when i went to college at 17; surely the advisor is a mental health advisor too. If thats the case why cant there be a 'Adult Mental Health Service', similary to CAMHS. I ended one the LD psych team and now i can't move to a mental health service because the label of my IQ is low, which is unfair.

 

Hi.

I do not know how much help I will be but I will have a go at answering your question.

It is unfortunate that services in adult mental health are often not as good as in CAMHS.

The issue of transition to adult services is complicated.It is very common for people to find that services within adult mental health do not offer the same support as CAMHS.

This applies to lots of mental health needs.

However ASD is a difficult area.

CAMHS provide some services where there are no equivalent services in adult mental health.

Adult mental health services are directed very much towards those with severe and enduring mental illness.

There is often little provision for adults with depression,anxiety or other very common mental health needs other than a GP prescription.

Also provision for ASD does not clearly fit within any specific service.

So as you say.Adults with ASD who have severe learning disabilities may well be supported by learning disabilities teams which are often part of the PCT or the LA and have no connection with mental health.

 

Adults with AS and severe enduring mental illness [schizophrenia,bi-polar disorder,severe depression for example] may well be supported by mental health services.However there is I think little specialist provision within mental health regarding ASD.So it partly depends on how suppportive and experienced individual professionals are.

There are some very highly specialist inpatient services for those with severe enduring mental health needs and ASD.However I think they are funded by the group that funds some of the speciaist educational private provision.There has been one case on the Forum for this sort of provision being funded but it is expensive and so is not undertaken by the purchases of care without careful consideration.

 

Adults who have AS and more common mental health needs such as depression and anxiety at a less severe level may find it difficult to access provision.

They may well be told that they do not qualify for the LD team because they have too high an IQ.

They may well not qualify for CMHT because the issues are not considered severe enough.

As I said.I know someone in my area has obtained funding through their PCT for counselling with an organisation that has experience of ASD.However this was the first time anyone had attempted to obtain this sort of support and it is only for twelve weeks.

 

Some forms of treatment have also traditionally not been offered to individuals with ASD which also limits access.

Some psychiatrists believed that people with ASD will not benefit from many of the traditional treatments for mental health needs.So they would not offer certain treatments.For example most professionals have always believed that people with ASD would not be able to build the relationship needed in order to benefit from psychotherapy.

Although my Ben has proved this not to be the case.

In almost anywhere else in the country Ben would not have been offered long term psychotherapy.

 

As in your case some people with ASD who are considered to have low IQ may not be offered support because their IQ is considered too low for them to benefit from treatment.

 

It is unfortunate that until about 1980 there was a qualification in nursing [learning disability] but it no longer exists.Nurses trained in learning disabilities were qualified to support people with ASD and mental health needs.

I trained as a nurse in 1984-1987.I also trained as a district nurse.There was at that time no requirement to have even the most basic training in learning disabilities such as Downs syndrome or ASD.

 

I do not know what DBT is ?

 

 

 

 

 

 

Perhaps I will now attempt to answer Mumble's question about ''Autistic Retreat '' too.

 

Some Mental Health Professionals come from a professional background where ASD was seen as a mental illness that needed a cure.

Professional language reflected this view.

Autistic Retreat is a specialist term used by psychotherapists.

The theory is that at some time when a child was less than three years old they experienced something very traumatic.

The child retreated as a way of coping with that thing that was too difficult to manage.

When the person is grown up and something reminds them [they do not know it reminds them it is all subconscious] of the original traumatic thing the adult then becomes withdrawn and isolates themself in order to cope.

So the withdrawal is described as ''Autistic Retreat''.

The theory does have some truth for all children and adults.

All of us have times of drifting off,daydreaming or becoming absorbed in an activity.

However when the professionals apply the idea to ASD they say that people with ASD do not become involved in activities because they enjoy them but as a way of retreating from things that are painful.So the answer is to treat the individual so that they can then relate to people and will no longer need to retreat.

Professionals that believe this theory do not believe that ASD is a learning disability or genetic condition.

They believe that ASD is a condition to be treated.

 

As you say this may well be a difficult approach for people such as Ben.

Ben considers that he is pleased to have AS.

I don't think he sees himself as in need of treatment.It is the people who expect Ben to fit in an NT box that need to change.

Unfortunately if a person has mental health needs and AS professionals may be very confused.

They may think that things that most people with AS think are part of AS are signs of mental illness.

Alternatively they may not provide support that could be helpful because they think the person is like they are because of AS whereas some support or treatment might be helpful.

 

There are no easy answers.

 

Mumble it may help if you think about the specific things you feel you need help with.

Think about the issues that you feel are ASD related that perhaps you don't want help with.

 

I know that there is a new job within the mental health team.

The job does not require a very high level qualification.

It is basically about the professional providing support on a very practical level to help with specific day to day needs.

A bit like having a PA.

I cannot remember the job title but I will find out.

I remembered because I was interested myself in the job.

I will see if I can find out some more information for you.

From previous posts it sounded as though having a professional like that might be helpful.

If you have done a lot of work with a counsellor through university then it might also be worth thinking about whether this is something you wish to begin again.

You may feel that getting to know a counsellor might be more than you can manage at the moment.

I know it must be a very uncertain time.

 

If it is any consolation I do understand.

I am finding it very difficult to get used to the idea of Ben finishing with CAMHS which is the main support he has even though he is very well.

Karen.

 

 

 

 

 

[Special_talent123]

sorry i will rephrase what DBT is and stands for- Dialectical Behaviour Therapy, used for people who have a Borderline Personality Disorder and i have heard people with Bipolar can use that too. But its 1 year waiting list and have to be referred through your team, but i don't exactly know if it will benefit the needs to people who have a LD/or ASD.

 

The worry is okay, The LD team can put a referral in for DBT but won't put a referral into Mental Health Service because of our low IQ, which is silly then why put a referral in DBT if they can't have access to the Mental Health Service. It doesnt make sense. I mean you can't have access to a crisis team if you don't have a mental health team.

[Karen A]

sorry i will rephrase what DBT is and stands for- Dialectical Behaviour Therapy, used for people who have a Borderline Personality Disorder and i have heard people with Bipolar can use that too. But its 1 year waiting list and have to be referred through your team, but i don't exactly know if it will benefit the needs to people who have a LD/or ASD.

 

The worry is okay, The LD team can put a referral in for DBT but won't put a referral into Mental Health Service because of our low IQ, which is silly then why put a referral in DBT if they can't have access to the Mental Health Service. It doesnt make sense. I mean you can't have access to a crisis team if you don't have a mental health team.

 

Hi.

I thought I should say first that I do not have any professional training in mental health.

Although I am a registered general nurse because I trained I am currently not registered to work as I have not worked since I had my boys.

So I am posting as a member of the public who has some knowledge and a lot of personal experience of psychotherapy but not an expert.

 

Do you have an ASD diagnosis already ?

Do you have a Mental Health Diagnosis too ?

 

I had not come across DBT before.

If you go to the Mind Website and look up Dialectical Behaviour Therapy there is some useful information.

 

 

http://www.mind.org.uk/

 

It appears that although DBT is fairly new the results of trials have been good enough for NICE [the organisation that monitors various treatments] to endorse it as a suitable treatment for BPD.

I do not know how much research has been done into the use of DTB in ASD.

However DTB appears similar to Cognitive Behaviour Therapy.

DTB appears to have in fact developed out of CBT.

CBT and DTB are generally more to do with helping people change things in life or ways of thinking that make life difficult.

The sort of psychotherapy I have had [dynamic psychotherapy] is much more to do with the development of a relationship with a therapist and with helping the individual have insight into their difficulties.

Dynamic Psychotherapy is usually not offered to people with ASD because it has not been shown to be helpful.

However where talking therapy is offered to people with ASD cognitive behaviour therapy has I think been demonstrated to be more effective.

So I would guess that if you were considering accepting the offer of talking therapy that DBT might be worth considering.

 

It would help if the therapist had some understanding of ASD.

However there are long waiting lists for all forms of talking therapy.

If you are offered DTB it may be worth giving it a go and seeing how you get on.

In my experience having a therapist that you can trust and get on with is far more important than how much training they have.

Research has confirmed that fact.

So even if the therapist does not know much about ASD it may well be worth having a few sessions of DBT to see how you get on.

 

Although you may gather that my experience of therapy has been difficult at times dynamic psychotherapy involves lots of thinking about difficult things.

DTB involves much less exploration of personal history and childhood issues.So it is much less likely to explore things that could be difficult.

 

If there is a one year waiting list it may well be worth getting your name on the list.

If you decide later that you do not want DTB it would be easy to ask your name be taken off the list.

 

Karen.

Edited November 30, 2009 by Karen A

[Special_talent123]

Hi.

I thought I should say first that I do not have any professional training in mental health.

Although I am a registered general nurse because I trained I am currently not registered to work as I have not worked since I had my boys.

So I am posting as a member of the public who has some knowledge and a lot of personal experience of psychotherapy but not an expert.

 

Do you have an ASD diagnosis already ?

Do you have a Mental Health Diagnosis too ?

 

I had not come across DBT before.

If you go to the Mind Website and look up Dialectical Behaviour Therapy there is some useful information.

 

 

http://www.mind.org.uk/

 

It appears that although DBT is fairly new the results of trials have been good enough for NICE [the organisation that monitors various treatments] to endorse it as a suitable treatment for BPD.

I do not know how much research has been done into the use of DTB in ASD.

However DTB appears similar to Cognitive Behaviour Therapy.

DTB appears to have in fact developed out of CBT.

CBT and DTB are generally more to do with helping people change things in life or ways of thinking that make life difficult.

The sort of psychotherapy I have had [dynamic psychotherapy] is much more to do with the development of a relationship with a therapist and with helping the individual have insight into their difficulties.

Dynamic Psychotherapy is usually not offered to people with ASD because it has not been shown to be helpful.

However where talking therapy is offered to people with ASD cognitive behaviour therapy has I think been demonstrated to be more effective.

So I would guess that if you were considering accepting the offer of talking therapy that DBT might be worth considering.

 

It would help if the therapist had some understanding of ASD.

However there are long waiting lists for all forms of talking therapy.

If you are offered DTB it may be worth giving it a go and seeing how you get on.

In my experience having a therapist that you can trust and get on with is far more important than how much training they have.

Research has confirmed that fact.

So even if the therapist does not know much about ASD it may well be worth having a few sessions of DBT to see how you get on.

 

Although you may gather that my experience of therapy has been difficult at times dynamic psychotherapy involves lots of thinking about difficult things.

DTB involves much less exploration of personal history and childhood issues.So it is much less likely to explore things that could be difficult.

 

If there is a one year waiting list it may well be worth getting your name on the list.

If you decide later that you do not want DTB it would be easy to ask your name be taken off the list.

 

Karen.

 

Thank you Karen i were bare that in mind

 

Yes i do have ASD

Yes i do have Mental Health diagnosis- but my main one are BPD with depression

[Mumble]

Hi Karen,

 

Thanks for the time you've put into these responses - they really are very helpful, giving me some issues to consider and to raise with others.

 

Adult mental health services are directed very much towards those with severe and enduring mental illness.

There is often little provision for adults with depression,anxiety or other very common mental health needs other than a GP prescription.

Also provision for ASD does not clearly fit within any specific service.

This appears to be very true and also fits in with many people's assumptions/stereotypes of mental health - someone on another thread talked about dealing with the delusions of those with mental health difficulties, but this is only one aspect - in fact anxieties etc. are more common and this is where the support falls down, even more so where, as in the case of many with ASDs, the difficulties arise as a result of unmet support needs rather than something intrinsic to the individual.

 

I know that there is a new job within the mental health team.

The job does not require a very high level qualification.

It is basically about the professional providing support on a very practical level to help with specific day to day needs.

A bit like having a PA.

I cannot remember the job title but I will find out.

I remembered because I was interested myself in the job.

I will see if I can find out some more information for you.

From previous posts it sounded as though having a professional like that might be helpful.

This is the sort of support I need, delivered within a flexible framework, whereby I have someone to help me organise myself (i.e. help me help myself rather than do things for me) at times when things feel overwhelming. I think it is similar to that proposed under the new Autism Bill of 'Low-Level Support'. What isn't clear is who will be responsible for/deliver this and I think this is where the problem is - it's almost as if we need a separate 'social health' department or similar because I can understand the reluctance of MH services to take us on when we don't fit and they can't support us effectively.

 

Some Mental Health Professionals come from a professional background where ASD was seen as a mental illness that needed a cure.

Professional language reflected this view.

Autistic Retreat is a specialist term used by psychotherapists.

The theory is that at some time when a child was less than three years old they experienced something very traumatic.

The child retreated as a way of coping with that thing that was too difficult to manage.

When the person is grown up and something reminds them [they do not know it reminds them it is all subconscious] of the original traumatic thing the adult then becomes withdrawn and isolates themself in order to cope.

So the withdrawal is described as ''Autistic Retreat''.

The theory does have some truth for all children and adults.

All of us have times of drifting off,daydreaming or becoming absorbed in an activity.

However when the professionals apply the idea to ASD they say that people with ASD do not become involved in activities because they enjoy them but as a way of retreating from things that are painful.So the answer is to treat the individual so that they can then relate to people and will no longer need to retreat.

Professionals that believe this theory do not believe that ASD is a learning disability or genetic condition.

They believe that ASD is a condition to be treated.

:rolleyes: What nonsense! (Their ideas, not yours!! ). Unfortunately, I have come across such opinions, not just in mental health but also in other medical professionals who absolutely refused to take into account my ASD or accept it as having a neurological basis, wanting to put everything down to my childhood. The fact that they refuse to accept the genetic side when there is research to prove this suggests that they are wrong, and they really should be held accountable if they continue to perpetuate and use such believes because they risk doing an awful lot of harm.

 

In my experience having a therapist that you can trust and get on with is far more important than how much training they have.

Completely agree. I've tried a few different people before finding someone I am comfortable with (that's different from finding someone who agrees with me - we still disagree or I'll tell her things don't work/make sense). The uni counsellor I see isn't expert in ASD nor claims to be, but instead we have worked together to adapt a CBT approach that works for both of us. In a sense we're both learning from each other. What has really worked is not having the time constraints of a usual 6/12 week CBT course that would be offered by MH (if you get any at all). It's taken that time to learn to work together and it wouldn't have been successful had support been limited to that time frame. Being part of the uni support, I can have ongoing weekly sessions and have done for most of this year. I would suggest that for many individuals with an ASD, they need this time to develop not only trust but an understanding of the way the therapist communicates and this needs to be integrated into the support offered. I guess it all comes down to understanding that everyone is an individual and as such support needs needs to be considered/offered on an individual basis.

 

[Karen A]

Thank you Karen i were bare that in mind

 

Yes i do have ASD

Yes i do have Mental Health diagnosis- but my main one are BPD with depression

 

A dual diagnosis of ASD and BPD is a complicated and I would think very uncommon combination.

It may be very difficult to find a therapist that knows a lot about both.

However it may sound like a strange way to look at things.

But many adults with ASD and anxiety or depression find it very difficult to obtain help within the NHS.

At least with a BPD diagnosis you are more likely to be offered some support.

http://www.nas.org.uk/nas/jsp/polopoly.jsp?d=1350&a=3277

This information from NAS might also be useful.

It explains more about CBT and AS and what to think about when deciding whether to work with a counsellor or therapist.

Karen.

 

[Karen A]

This is the sort of support I need, delivered within a flexible framework, whereby I have someone to help me organise myself (i.e. help me help myself rather than do things for me) at times when things feel overwhelming. I think it is similar to that proposed under the new Autism Bill of 'Low-Level Support'. What isn't clear is who will be responsible for/deliver this and I think this is where the problem is - it's almost as if we need a separate 'social health' department or similar because I can understand the reluctance of MH services to take us on when we don't fit and they can't support us effectively.

 

Hi Mumble.

I cannot remember what the exact job title was,cannot find the original post about the job and cannot find the job advertisement.

I think Pearl might have posted about it.The job was a role within Mental Health Teams.It covered both hospital and the community for a given client.I think the idea was to have an individual who actually did things to solve problems.It was very practical and did not need lot of qualifications.It was payed at about the level of a senior health care assistant.

In my local Mental Health Trust when I read the advertisement they were far more interested in finding the right people with the right attitudes than with qualifications.

I remember a lot because I have an eye open for future work options at some point and was interested myself.

 

My husband might know exactly what the job was called.If I find out I will let you know.

 

Karen