Therapeutic Strategies for Adults with ASD. Professional and Social Adaptation 330
LCSW-R, Master’s in Social Work, is a Psychotherapist in Private Practice, and the DIR-Expert, The Interdisciplinary Council on Development and Learning (ICDL), New York, USA
Clinical tools available to clinicians working with autists are mostly geared to the child and adolescent population: providing early intervention therapies, building academic skills, resolving school age behavioral problems etc. Yet, with the first wave of those diagnosed during the recent “autism epidemics” reaching adulthood, and with advancement in age of those diagnosed earlier, there is an emerging need for new methods. Due to the neurodiversity movement and growing self-awareness of the autistic community, grown-up individuals with ASD rely notably less on the strictly behavioral tools and yearn for comprehensive, sensible strategies to address their complex social and emotional needs. This paper examines unique challenges of adulthood that autists face: e.g., finding an authentic professional self, building and maintaining relationships, all while dealing with additional challenges of their unique developmental profiles. It also discusses making choices of therapeutic techniques, and details benefits and rewards of play- and affect-based therapeutic work. Using DIRFloortime and mentalization strategies offers multiple opportunities for spontaneous, improvised psychotherapeutic contact in the context of unstructured playful intervention. Such work is aimed at building the unique support system for autists and for their families and partners. Case vignettes of adult clients with ASD are used.
Greenspan S.I., Wieder S. Na ty s autizmom:
ispol'zovanie metodiki Floortime dlya razvitiya otnoshenii, obshcheniya i
myshleniya [Engaging autism: using the Floortime approach to help children
relate, communicate and think]. Moscow: Publ. Terevinf, 2013. 512 p. ISBN
Baron-Cohen S., Leslie A.M., Frith U. Does the
autistic child have a “theory of mind”? Cognition, 1985, vol. 21, no. 1,
pp. 37–46. DOI:10.1016/0010-0277(85)90022-8
Bateman A.W., Fonagy P. Mentalization Based
Treatment for Personality Disorders: A Practical Guide. 1st Edition. New York:
Oxford University Press, 2016. 474 p. ISBN 978-0-19968037-5.
Bateman A.W., Fonagy P. Handbook of Mentalizing in
Mental Health Practice. 2nd ed. Washington: American Psychiatric Association
Publishing, 2019. 446 p. ISBN 978-1-61537-140-2.
Benvenuto S. Autism: A battle lost by
psychoanalysis. Division Review, 2019, no. 19, pp. 26–32.
Bretherton I., McNew S., Beeghly-Smith M. Early
person knowledge as expressed in gestural and verbal communication: When do
infants acquire a ‘theory of mind’? In Lamb M.E., Sherrod L.R. (eds.) Infant
social cognition. Hillsdale: Lawrence Erlbaum, 1981. Pp. 333–373. ISBN
Casenhiser D.M., Shanker S.G., Stieben J. Learning
through interaction in children with autism: Preliminary data from
asocial-communication-based intervention. Autism: the international journal of
research and practice, 2013, vol. 17, no. 2, pp. 220–241.
Clynes M. Sentics: The Touch of Emotions. Garden
City: Anchor Press, 1978. 281 p. ISBN 0-38508622-9.
DeVincentis R.D. A Dynamic Exploration into
Mentalization Among Youth on the Autism Spectrum: Ph.D. dissertation / Antioch
University. Keene, 2018.
Gallese V. Intentional attunement: Mirror neurons,
inter-subjectivity, and autism. In La Sala G.B., Fagandini P., Iori V., Monti
F., Blickstein I. (eds.) Coming into the world: A dialogue between medical and
human services: International Congress "The 'Normal' Complexities of Coming
into the World", Modena, Italy, 28-30, September 2006. Berlin; New York: Walter
de Gruyeter, 2006. Pp. 45–64. ISBN: 978-3-11-019018-2.
Grandin T., Barron S. The Unwritten Rules of Social
Relationships: Decoding Social Mysteries Through the Unique Perspectives of
Autism. Arlington: Future Horizons, 2005. 383 p. ISBN 1-932565-06-X.
Grandin T. Thinking in pictures: and Other Reports
from My Life with Autism. — London: Bloomsbury, 2014, 304 p. ISBN
Greenspan J., Greenspan S.I. Functional Emotional
Developmental Questionnaire for Childhood: A Preliminary Report on The
Questions and Their Clinical Meaning. Journal of Developmental and Learning
Disorders, 2002, no. 6, pp. 71–116.
Leekam S.R., Nieto C., Libby S.J., Wing L., Gould
Describing the Sensory Abnormalities of Children and Adults with Autism
[Web resource]. Journal of Autism and Developmental Disorders, 2007, vol. 37,
no. 5, pp. 894–910. URL:
(Accessed 21.05.2020). DOI:10.1007/s10803-006-0218-7
MacNamara J., Baker E., Olsen C. Four-year olds’
understanding of Pretend, Forget, and Know: evidence for propositional
operations. Child Development, 1976, vol. 47, no. 1, pp. 62–70.
Premack D., Woodruff G. Does the chimpanzee have a
‘theory of mind’? Behavioral and Brain Sciences, 1978, vol. 1, no. 4, pp.
Shanker S.G. In Search of the Pathways That Lead to
Mentally Healthy Children. Journal of Developmental Processes, 2008, vol. 3,
no. 1, pp. 22–33.
Shaputis K. The crowded nest syndrome: surviving
the return of adult children. Olympia: Clutter Fairy, 2003. 144 p. ISBN