ASD, anxiety and counseling

[macchiatto]

This week, Leo is finally starting counseling for the first time (for his anxiety). He's also currently getting ST (social skills, and she's also going to be working with him on his understanding of concepts related to emotions and friendships/relationships), PT and OT. 

The  first appt is going to be just me and his new counselor for an assessment, and Leo will start seeing her next week.

Any suggestions on things I should ask about, request, etc.? Since there is somewhat of a psychoeducational component to his ST (she's incorporating MGW's Social Thinking curriculum) and even his OT (like working with him on getting "just right" in sensory ways and recognizing when he's overstimulated), I'm not entirely clear on what goals would be best for counseling or what the overlap might look like for a kid with anxiety and mild ASD. I've had trouble finding a therapist; this one does have some ASD experience (more than anyone else I've been able to find) but I'm not sure how much. He's had multiple rounds of ST, OT and PT since he was 2.5 (he's now 8.5) but this is his first round of counseling/psychotherapy.

His DP had mentioned the Coping Cat curriculum might be good for him with his anxiety so I might mention that to his counselor. Any experience with that?

[auntie]

In a hurry.

I'd want to know which of the MGW approaches is being used- and why that is a good fit for Leo. At this age Superflex and Thinking About You Thinking About Me seem like the logical choices.

Coping Cat is CBT based- I am a fan of CBT for helping kids get more growing their comfort zone.

[miranda]

Really interested to hear how this goes for you. We've tried three therapists and one group therapy and haven't had luck- yet. DS hated it, and thus wouldn't participate. He adores his psychiatrist though, so I know there is such a thing as an adult he'll click with. I haven't heard of Coping Cat but it looks really interesting. I might order a workbook off Amazon. Be vocal with your IEP team if it's a technique that seems to work for Leo, so they can incorporate it at school.

[auntie]

CBT is about reframing/thinking, if he's not to a place where he can do that kind of work- maybe a self regulation program could be an option. You mention being "overstimulated"- maybe this-

www.alertprogram.com/

[macchiatto]

Thanks for the feedback! I'm not sure yet how CBT will go with him, if he's ready for it yet. I could see it making sense to him and being helpful. He struggles with recognizing different emotions (and with flipping right to panic) so I'm curious to see how that will show up in counseling.

His ST is actually here working with him right now. She's doing an exercise with him explaining flexible vs rigid thinking. I can ask which she's using. I know you had recommended her work for him but didn't realize she had multiple approaches to choose from. So far what she's been doing with him seems to be helpful; he seems to be really getting it. (They also worked on size of the problem and how to respond, and that seems to help with calming him down when he starts to panic.)

[auntie]

Jul 19, 2017 14:53:41 GMT -5 macchiatto said:

Thanks for the feedback! I'm not sure yet how CBT will go with him, if he's ready for it yet. I could see it making sense to him and being helpful. He struggles with recognizing different emotions (and with flipping right to panic) so I'm curious to see how that will show up in counseling.

Working to identify his level of arousal (yes, that's what they call it) on a scale of tuned out to flipping out,  would probably be a good first approach. CBT involves a degree of self awareness; you can't put the strategies into play if you are too anxious to access them. DS was able to go straight to CBT because he's not the kind of kid who ever tantrummed which is really weird. 


His ST is actually here working with him right now. She's doing an exercise with him explaining flexible vs rigid thinking. I can ask which she's using. I know you had recommended her work for him but didn't realize she had multiple approaches to choose from. So far what she's been doing with him seems to be helpful; he seems to be really getting it. (They also worked on size of the problem and how to respond, and that seems to help with calming him down when he starts to panic.)

That may be Superflex. The MGW stuff overlaps age groups, but the range of products also allow an SLP to fine-tune the intervention to each kid's individual brand of ASD. Superflex can be great for a kiddo who is anxious and reactive because of rigid behavior and thinking. It also segues into TAYTAM, which is generally aimed at slightly older kids and taking ownership of how one's behavior drives how others see and treat you. 

The SLP should give you homework so you can reinforce the strategies the rest of the week. 

[macchiatto]

Thank you, auntie! The SLP does give us some homework.

The counseling appt went pretty well, I think. We'll see how things go; Leo sees her for the first time on Monday.
One thing she tentatively plans to incorporate is the Stepping Stones Triple P approach. (She gave me a booklet to read through and see what I think.) Are any of you familiar with that approach?