UK Autism NICE guidelines

Simbindi

Simbindi

Senior Member (Voting Rights)
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Ariel said:
Is there generally any acknowledgement that autistic people might respond differently to CBT than others?
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I'm not sure of the formal evidence, but it does seem to be recognised by the NHS that CBT needs to be adapted for autistic people. However, antidotally I know a number of autistic peers who have been left traumatised by it.
 
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Simbindi said:
I'm not sure of the formal evidence, but it does seem to be recognised by the NHS that CBT needs to be adapted for autistic people. However, antidotally I know a number of autistic peers who have been left traumatised by it.
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Thats interesting, hadn't heard that before. I can add an anecdote - I had CBT for anxiety (et al) and might possibly be autistic. I do feel sort of traumatised by a good chunk of it, felt gaslit and struggled to trust myself afterwards, and am more convinced now than ever of the bottom line beliefs they tried to change. It was also incredibly frustrating, illogical, and failing at it felt shameful at the time.
 
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Haveyoutriedyoga said:
Thats interesting, hadn't heard that before. I can add an anecdote - I had CBT for anxiety (et al) and might possibly be autistic. I do feel sort of traumatised by a good chunk of it, felt gaslit and struggled to trust myself afterwards, and am more convinced now than ever of the bottom line beliefs they tried to change. It was also incredibly frustrating, illogical, and failing at it felt shameful at the time.
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I've just skimmed the NICE guidelines on adult autism and they were updated in June of this year.

There is a section addressing this in them now (I don't remember that in the older version):
1.6 Interventions for coexisting mental disorders

1.6.1 Staff delivering interventions for coexisting mental disorders to autistic adults should:
  • have an understanding of the core features of autism and their possible impact on the treatment of coexisting mental disorders

  • consider seeking advice from a specialist autism team regarding delivering and adapting these interventions for autistic people.
Psychosocial interventions for coexisting mental disorders

1.6.2 For autistic adults and coexisting mental disorders, offer psychosocial interventions informed by existing NICE guidance for the specific disorder.

1.6.3 Adaptations to the method of delivery of cognitive and behavioural interventions for autistic adults and coexisting common mental disorders should include:

  • a more concrete and structured approach with a greater use of written and visual information (which may include worksheets, thought bubbles, images and 'tool boxes')

  • placing greater emphasis on changing behaviour, rather than cognitions, and using the behaviour as the starting point for intervention

  • making rules explicit and explaining their context

  • using plain English and avoiding excessive use of metaphor, ambiguity and hypothetical situations

  • involving a family member, partner, carer or professional (if the autistic person agrees) to support the implementation of an intervention

  • maintaining the person's attention by offering regular breaks and incorporating their special interests into therapy if possible (such as using computers to present information).
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https://www.nice.org.uk/guidance/cg...interventions-for-coexisting-mental-disorders
 
What I don't think this guidance in the updated NICE autism guidelines recognises, is that advice given by CBT therapists is often illogical, contradictory and judgmental. Many of us have depended on our logic and cognitive abilities to navigate the social world and interactions, so any challenge to that is both likely to be wrong in content and has the potential to create severe trauma and PTSD in autistic people.
 
Simbindi said:
What I don't think this guidance in the updated NICE autism guidelines recognises, is that advice given by CBT therapists is often illogical, contradictory and judgmental. Many of us have depended on our logic and cognitive abilities to navigate the social world and interactions, so any challenge to that is both likely to be wrong in content and has the potential to create severe trauma and PTSD in autistic people.
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Or, indeed, in anyone else who prefers their medical interventions to have some rational basis.
 
Simbindi said:
I've just noticed the NICE autism guideline for adults was update in June 2021. I am just skimming them and they seem more detailed than previously.
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Interesting, thank you. Will take me a while to read them properly, but in the meantime I do wish somebody would offer me a health passport! I mask so well that nobody has a clue unless they're trained, and there are occasional moments where it might make a genuine difference.
 
We have to look after out own medical needs as we are very neglected. It is perfectly valid to make your own passport or have a card or a medic alert. My grandson wears dog tags which explain he is autistic with severe social anxiety.

If medical staff are caring they will be glad to know of any problems you may have and if they are snippy or sarcastic, well, it prepares you for how they will treat you about everything.
 
Kitty said:
Interesting, thank you. Will take me a while to read them properly, but in the meantime I do wish somebody would offer me a health passport! I mask so well that nobody has a clue unless they're trained, and there are occasional moments where it might make a genuine difference.
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if you are talking about the autism health passport - you can fill that in by yourself at home (I did!).

https://www.autism.org.uk/advice-and-guidance/topics/physical-health/my-health-passport
 
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