Abstract
Adolescents with autism spectrum disorder (ASD) are vulnerable to trauma-related experiences due to difficulties in emotion recognition, including recognising their own and others’ emotions, leading to interpersonal conflict and problems in making and maintaining friendships. There are limited intervention methodologies of how to work with interpersonal conflict and relational repair. This paper presents, for the first time, a case conceptualization model of relational rupture and repair as a clinical strategy to guide therapists working therapeutically with clients with ASD. The model is constructed from a task analysis applied to dyads of therapy and Interpersonal Process Recall sessions of Emotion-Focused Group Therapy with autistic adolescents (EFGT-AS). This model shows that when therapists use Interpersonal Process Recall of shared trauma-related experiences and misempathy encounters as a process-guiding method, it leads to a deepening of emotional processing in both cognitive and affective empathy. Autistic adolescents are able to use EFGT-AS to explore self-agency within interpersonal ruptures and enhance self and other cognitive-affective empathy within a relational repair process. This rational-empirical model for working with relational rupture and repair stands as a hypothesis for future testing.
Highlights
Autism spectrum disorder (ASD) is a neurodevelopmental disorder, defined in behavioural terms based on qualitative deficits in social communication and restricted, repetitive thinking and stereotyped behaviour (American Psychiatric Association 2013)
To guide therapist focus in reducing trauma-related difficulties, a rational-empirical model is proposed. This process model is constructed from a grounded theory analysis of interviews, with 43 parents talking about their experiences of living with autistic adolescents coping difficulties during adolescence
This paper has presented a task analysis of EFGT with autistic adolescents
Summary
This case conceptualization is a task analysis of EFGT-AS carried out by the author over 11 weeks. The group consisted of three adolescents (mean age = 14.0): two females (14 and 15 years) and one male (13 years) in secondary mainstream education. The adolescents were formally diagnosed with Autism Spectrum Disorder by a psychiatrist or clinical psychologist using Diagnostic and Statistical Manual-IV (DSMIV) criteria (APA 2000). To illustrate markers extracts have been drawn from the participants across treatment. Drawn from Natalie (14 years), one of the female participants, and her experiential changes across therapy, with specific focus on her encounters with the other female, Jane (15 years). Natalie’s scores using the Client Emotional Processing Scale for Autism Spectrum (CEPS-AS; Robinson and Elliott 2016) for emotion processing, self-reflection, empathy and mental representation changed from low level processing at the beginning to moderate to high level processing at the end of treatment
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