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I am a certified AutPlay Therapist & use CBT for Adult with Autism





is a play therapy and behavioral therapy based treatment approach for working with children and adolescents affected by autism spectrum disorder and other neurodevelopmental disorders. AutPlay protocol is designed to identify and increase skill deficits and functioning levels in children and adolescents with developmental delays. Typical treatment involves using structured play therapy interventions designed to build relationship, increase engagement, and strengthen skill deficits.




BY ANNE ROUX AND CONNOR KERNS, Drexel Univerisity. Posted on March 30, 2016


Mental Health Needs:

Approximately 70% of the autistic population has at least one, if not multiple, co-occurring mental health issues. That figure comes from studies of children and adolescents, but we have no reason to believe that the prevalence of mental health conditions would decrease in adulthood. In fact, we’d expect that the numbers might be higher in adults, as social anxiety and depression often emerge during adolescence and are more common in adolescents with autism than in those with other types of disabilities. The symptoms of mental health conditions like anxiety, though, sometimes go unrecognized in people with autism, as the symptoms are sometimes falsely attributed to being part of what autism looks like.

When mental health issues go undiagnosed and unaddressed, their effects can accumulate across the life course. Mental health issues can impede follow-through on recommendations and can affect acquisition of life skills. Maybe a person neglects that recommendation to visit the disability supports office at college, or maybe she is too anxious to attempt to learn to drive. Trying to improve quality of life for people with autism who are dealing with untreated mental health issues is as difficult as trying to help a person lose weight if they’re depressed - unless you also address the depression.


in particular, is known to add to functional impairments in those with autism. Co-occurring anxiety increases self-injurious behaviors, suicidal ideation, poor social functioning, and family stress. But studies of children and adolescents suggest that when we treat anxiety, we may see improvement in symptoms of autism as a whole. This makes anxiety an appealing target for intervention. Let’s take our focus on anxiety a step further.

The Solution:

Fortunately, in addition to pharmacological treatment, we have evidence suggesting that cognitive behavior therapy (CBT) reduces co-occurring anxiety in children and adolescents with autism. There is no reason to suspect CBT doesn’t also have similar effects in adults.


The Solution

The problem is that most of the people who deliver services for adults with autism - including the many family members who are the primary daily support providers for adults - are not trained in CBT. It’s a circular problem. Few people realize there are answers for improving life for those with anxiety and autism, because few people recognize that anxiety exists separately from autism. So, what steps could we take to support mental health for adults with autism?

We think the answer is three-pronged. Transition-age youth and young adults with autism need to have access to awareness, education, and counseling about identification and management of co-occurring mental health conditions to ease the transition into adulthood and functioning as an adult. Service providers, educators, and family and friends who interact frequently with youth and adults with autism should be able to recognize co-occurring mental health issues, know when to refer to a psychologist for intensive treatment, and know steps for immediate interventions (e.g., coping strategies). Trained counselors should be available who understand autism, co-occurring mental health issues, and successful treatment/coping strategies for this population.

It is unlikely that we will ever have enough specialized psychiatric providers to meet the needs of so many adults with autism. But there are concrete steps that could be taken to increase the capacity of people in the community to at least provide mental health first aid. Here are a few:

  • Increase awareness of adolescents and adults with autism and their family members about anxiety, depression, and other emotional struggles, and increase their comfort in communicating these concerns to others without stigma.

  • Teach adults with autism how to tell if anxiety and depression are occurring, and how to tell when they’ve become problematic in and of themselves versus when they may be reactions to a situation.

  • For people with higher levels of impairment, educate families and providers about what anxiety/depression look like in more affected individuals.

  • Train service providers and educators in how to recognize co-occurring mental health symptoms, when to refer to a psychologist, and what to do for immediate, first level interventions.

  • Counsel adolescents during transition to teach self-awareness of mental health issues and improve coping strategies, beginning with reducing stigma around sharing with others that you feel anxious and depressed.

  • Encourage youth and adults to pursue help. Therapy can be focused on dealing with anxiety, but can also focus on helping the individual better understand themselves, their goals, and their personal development.

  • Help youth and young adults to determine when and how to disclose information about mental health issues to others.

  • Learn from adults on the spectrum about supports and strategies they find useful. Peer-to-peer support models are a key ingredient for managing anxiety for some people and have proven to be effective in dealing with severe mental illness. What else can we learn and adapt from those who have experience coping with anxiety and autism?

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