Goal IV: How to Develop Specific Steps in Deciding Which Techniques to Use When Working with People with Autism

This blog is a continuation of the goals of Relational Therapy. In this discussion I will emphasize how the caregiver or therapist develops specific steps in deciding which Relational Therapy techniques to use with individuals with Autism Spectrum Disorders.


• As mentioned previously, it is important to be flexible. The right technique with a given child/adolescent/adult will develop through spontaneous interaction with the individual.


• In determining the right technique at a given time, take the child’s lead and let him have control. The autistic individual does not have self-agency so by letting him have control you are letting him experience self-agency. As he experiences self-agency you can start to forge an interaction with him. He needs to see that he can have self-agency and he needs to know how to be in a relationship with another person. The autistic person learns interaction by being given the “space” to have a two-way dialogue. It is through the relationship with you that he learns about how to take and give space to others. This is a process that takes time. The amount of time will vary from person to person. Do not give up on the relationship if it takes months and years to establish the dialogue between you and the autistic person.


• The next step will be for the child to learn to be influenced by another person. This will be difficult to accomplish. For someone who has lived without self-agency, they will have many emotions that could not be expressed. As you work with the individual those feelings will start to be expressed. To be influenced by another person may mean and feel to the autistic person that they no longer have self-agency. They may feel that you are now taking away something that they have worked so hard to get. If trust has been established between the therapist/caregiver and the autistic person than the process of influencing can take place. It needs to be handled slowly and at a pace that the person with autism can manage (there will be future blogs on how to develop space, develop two-way dialogue and how to influence the autistic individual).


• It is important to be creative


• There are no right or wrong techniques, but there are ethical and unethical, legal and illegal techniques.


• The sequence of roles of the therapist/caregiver:
  1. Develop an appropriate frame for therapy
  2. Develop an environment for engagement and attachment with the child
  3. Help the child develop his ability to communicate in general
  4. Help the child identify feeling states within others
  5. Help the child identify feeling states within himself


• The primary areas of focus:
  1. Attachment and engagement
  2. Verbal Level I: nonverbal, echolalia – focus on helping the child develop an attachment and by helping the child find a means of communication, i.e. facilitated communication, etc.
  3. Verbal Level II: the child goes through the following in sequence - you, me, I (when the child can use “you” than you can use projective techniques).
  4. Verbal Level III: Communication of feelings
  5. The time frame that an individual child will take to go through the above areas will vary from child to child.

This blog has been an introduction on how to choose techniques when working with an autistic person. Future blogs will go into more detail about the areas that have been introduced here.