For years the treatment of autism has been dominated by a single treatment modality called applied behavioral analysis (ABA). ABA is a treatment modality that was designed for children in the early 1970s based on the principles of behavioralism to help children integrate into neurotypical society. It has been shown through a massive profundity of research to help autistic children function better in school environments, have significant increases in social engagements with peers, and reduce repetitive stereotyped and hyper-fixated behaviors.
However, emerging research shows that ABA does not help with the avalanche of mental health concerns that autistic adults have, and a few studies have begun to show it may make quality of life worse for older clients (Kupferstein, 2018). Whether or not this is true, ABA is not designed to help autistic adults combat all the stressors of trying to live as an autistic person in a neurotypical world. At this time, there is no agreed-upon treatment modality that improves quality of life and reduces depression, anxiety, and suicidal ideation among autistic adults.
The primary issue any treatment for adults has to address is masking. In the study “Death by Suicide Among People with Autism: Beyond Zebrafish” (2021), researchers found that adults with autism had three times the suicide rate of their non-autistic peers. They also found that when masking and camouflaging behaviors stopped, suicide rates were cut in half.
Another critical issue that needs to be addressed by any treatment is the low self-esteem that often accompanies autism in autistic adults. According to a 2020 study (Galvin, Howes, McCarthy, and Richards), there is a direct link between self-compassion and depression in people with autism. People with autism who view themselves as weird and push themselves to be normal suffer, with 41.9 percent higher rates of depression than those who learn to love themselves as they are and grant themselves self-compassion and understanding.
There are myriad other issues that need to be addressed, but one other I want to mention here is boundary setting and healthy relationship skills. According to Haruvi-Lamden et al (2020), 66 percent of autistic people have co-occurring posttraumatic stress disorder (PTSD). This means that traditional social-skills training for autistic people is helping them become more palatable to neurotypicals—but, in conjunction with autistic people’s struggles to read social cues, traditional social-skills training can also make autistic people vulnerable to predatory and toxic relationships that lead to PTSD.
In my new workbook, The Unmasking Workbook for Autistic Adults, I present a new treatment modality that focuses on improving quality of life and reducing suicidality and traumatization rather than making autistic people more normal. The treatment modality, Spectrum Unmasking and Acceptance Therapy (SUAT), has nine stages that begin with self-excavation, continue through comping skills for autistic meltdown and burnout, understanding emotions, and learning boundary-setting to help autistic adults learn how to live and thrive in a world that wasn’t meant for them.
There is a mental health crisis among autistic adults that has been largely ignored. Once autistic children learn how to mask and act normal, most people assume that things are right as rain, but the opposite is true: According to Dewalt et al (2018), “the rate, timing, and causes of death in a large community-based cohort of adolescents and adults with ASD (n = 406) over a 20-year period (1998-2018) … identified predictors of mortality. Over this period, 6.4% of individuals died at an average age of 39 years.” This rate went up to 58 for those with “high-functioning autism.” According to a study done by Alicia Broderick (2022), masking is the largest cause of emotional distress in people with autism. She found that the very act of trying to be normal and fake social skills causes significant depression and anxiety.
Over the last 10 years, the poor quality of life for autistic adults has become more central to the conversation. Autism self-advocates and autistic adults have come forward and begun to speak out to let the world know that more needs to be done.
Over the last 10 years, I have spent most of my time working with autistic adults and listening to their concerns. I have been diagnosed with autism myself, and what I have learned in this journey is that the only way through all the anxiety and depression is to find a path to understanding the inner workings of our unique minds, accepting that we are different, learning how to cope with our difference, and learning to love ourselves for who we are and live an authentic life.
Oddly, in my experience, the hardest part for most autistic people is usually the first part. Most autistic people struggle the most with accepting that it is OK for them to be autistic and be different. They want to be normal and fear being disliked and shunned. They struggle with the concept that they don’t have to hide being autistic and that they shouldn’t be ashamed of being autistic.
Source: jessica penot
This is where we can work together as a society to make things easier on autistic people. We can work on supporting autistic people. We can avoid judging others for being different and work on acceptance and kindness.
As I move forward in my work, I hope that my clients find a world that is more accepting, so that my work becomes easier and maybe even unnecessary. I was lucky; my family and friends have largely supported my acceptance and unmasking. They have celebrated my oddities and encouraged me to be myself. My hope is that all autistic people can eventually find this kind of support in the world so that unmasking and acceptance can become the norm.
Source link : https://www.psychologytoday.com/za/blog/the-forgotten-women/202410/a-better-way-to-help-adults-with-autism
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Publish date : 2024-10-08 21:00:52
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