Hi, and welcome to part 6 in my series about working together in the therapy room with autistic clients.

In this post, I’d like to talk about what goes on in therapy. There might be “set-backs”, there might be a need to set clear goals in order to set the client up for success, and using problem-solving approaches might help with this.



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)


In the intro for this post I wrote “set-backs”.

This is something that I don’t consider the correct wording, but clients might use this language, so let’s go with it.

I trust in the work that we do in each session with my clients.

Sometimes therapy is counter-intuitive.

Clients might get worse before they get better, and riding that out might be tricky to understand or grasp.


Explaining – psychoeducating – an autistic client about the fact that this is going to happen and how it might look like, in general terms, might help keep the anxiety about these “set backs” to a low level.

Working through the anxiety of feeling like we took some steps forward and coming back for a future session thinking that the work has been undone is something I’m familiar with.

It happens with both autistic and non-autistic clients. It’s all part of the process.


Using visual aids or diagrams might help clients understand this and trust that what they’re doing is getting them ahead rather than falling behind.

I trust that, in the way we work in the room, once we have taken steps forward, we can never go back to square one.

There might be the chance of going back 3 steps but never the 10 we’ve already walked.

The change that happens is organic most of the time, and if it hasn’t “clicked” yet, then it just means we need to continue working until we have reached the full depths of the origin of the issue.


Therapy is like an archaeological dig or a police investigation. We are connecting the dots, putting things back together in order to get a clear picture and set goals to move forward.

Setting clear goals is something that I don’t do in an overt fashion with my clients, but it might actually be very helpful to focus the mind of an autistic client.


Using problem-solving approaches might be ideal to support an autistic client with what they want to work through.

There might be the need for some flexibility within the goal and how to reach it, following my usual way of working (free association) but having that goal will allow us to focus and possibly measure the changes as we go through the sessions.

Figuring out in therapy how to get from A to B, and what will be helpful to each individual client is important and is something that we learn together as client and therapist.


Let me know if you have any questions and comments.


Autism/Aspergers – Working together in the therapy room (mini-series- pt.6)