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Autism/Aspergers – Working together in the therapy room (mini-series- pt.4)


Hi, and welcome to this week’s post, part 3 in my series about working together in the therapy room with autistic clients.

This week want to talk about some alternative ways of working that might be helpful when communicating with our autistic clients in the therapy room.


Read part 1, 2 and 3 here.

I’ve also written a few posts about what to expect on your first counselling session (read part 1 and part 2 here).

You can also click here for my other posts on Autism.


For these posts, I’d like to reference Katherine Paxton and Irene A. Estay’s book called Counselling people on the Autism Spectrum (chapter 3)


Carol Gray’s writings (In Paxton and Estay) highlight the fact that using visual aids in the sessions might help our clients process what they’re bringing to their sessions.

In my past role as a support worker, I have used social stories for things such as transitions, staff changeover, leaving the house for an activity, room changes, and other similar things for the young people and adults I’ve looked after.


I have created a pictorial contract in a similar fashion, which has been received well.

When I send my contract to autistic clients, I might send the pictorial version along with it, and it’s in the client’s choice to open it or just read the non-pictorial version.

I’ve had positive feedback and I’ve been really careful as to not make assumptions over whether the client will be able to read one or the other. I send both and that way the client decides what is most helpful for them.


I have a whiteboard in my therapy room, which is generally for my tutoring students, but it’s been very handy in my therapy sessions too.

I have drawn or made diagrams of what we’re discussing, or clients have used the board themselves to explain how they process information and how they understanding something.

This helps me gain some insight into how best to relay what I’m trying to say, and meet my client where they are.

It’s amazing how visualising something can bring so much clarity! Sometimes words escape me – or my clients – and drawing it or making a diagram might help.


A third thing I use is physical tools and games. I have stress balls where the clients can see them, and I offer them if they seem to need them (some might not want to go near them as they don’t know who grabbed them beforehand! others are quite happy with talking and squeezing the stress balls during the sessions).

I also have playdough, skittles, draughts and a tiny bin where clients can write what they want to process or get rid of and put it in the bin (of course it’s not that simple, but the concrete, observable act, is a start and part of the process).


I’ve not done this yet, but if requested, or if I think it might be useful, I can make a summary of the session, either with the client or send it after the session, for further thinking and processing.

Another way of working is to use emotional thermometers, bar graphs and other tools to facilitate identifying and measuring emotions in a more visual and concrete way.

In my work, I try to bring clients (autistic or not) to think more in the “greys” rather than just black and white. Using the emotional thermometers and similar tools might help achieve this.


Estay and Paxton (pg.79) point out that some of these aids might be rejected as clients might feel that these are being used because of their autism rather than as a tool to help them. As I said before, I have used these techniques with all my clients, and I’d make sure that they knew this before using the techniques.


All of these will help with the thinking process, as well as with the processing of emotional content that the clients might be bringing into the room.


Have you got any more ideas that have helped with your own clients?

If you are autistic and have other ideas that might help counsellors understand what you need from us in therapy and how best to support you in your therapeutic journey, do let me know and I’ll be happy to add them to this post.


Until next week…


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