Therapeutic Strategies for Adults with ASD. Building Romantic and Intimate Relationships; Starting Family.



This paper further examines unique aspects of emotional life of adults with ASD and challenges and rewards of building long-term romantic and family relationships. Psychotherapeutic methods of choice, DIRFloortime and mentalization, are aimed at forming, maintenance and flexible repair of the interpersonal relationship: DIRFloortime offers play- and affect-based strategies and helps to build interpersonal relationship, while mentalization techniques provide metacognitive intervention and serve as scaffolding for emotional thinking and higher-level cognition. Techniques of Floortime play, Socratic questions and collateral work proved to be effective. Clinical vignettes illustrate moving the entire family up towards more effective and harmonious co-regulated interaction with corrections to sensory triggers, elements of psychoeducation about self-regulation, and direct self-regulation individual coaching. Coregulating affect, raising self-awareness, demonstrating relationship building and repair, as well as interest in the other in the course of playful interaction; waiting and gently prodding into the emotionally meaningful subjects helps the therapist to help adult autists to erect the societal support system.

General Information

Keywords: autistic spectrum disorders (ASD), emotional development, DIRFloortime, adult psychotherapy, mentalization, affect-based therapy, theory of mind, playful interaction

Journal rubric: Education & Intervention Methods

Article type: scientific article


For citation: Itskovich G. Therapeutic Strategies for Adults with ASD. Building Romantic and Intimate Relationships; Starting Family.. Autizm i narusheniya razvitiya = Autism and Developmental Disorders, 2021. Vol. 19, no. 3, pp. 15–22. DOI: 10.17759/autdd.2021190302. (In Russ., аbstr. in Engl.)


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Information About the Authors

Galina Itskovich, 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, ORCID:, e-mail:



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