Therapeutic Assessment of Autism

In the early days, I used to conduct autism assessments that answered one question, "Am I autistic?" For some folks, that's exactly what they want and are satisfied to walk away with either a "Yes" or "No" response.

However, most neurodiverse people tend to be a curious bunch... who think deeply... and really want to dig in when it's a topic that they're interested in... so... in those cases a "Yes" or "No" may leave them feeling unsettled!

Let's say someone is autistic. What are some types of follow-up questions people often have?

• Are all of my traits due to autism or is it something else?

• Do I have any other diagnoses and, if so, do they overlap with autism?

• Am I exhausted by social interactions because of autism? because of mood? because of poor sleep? because I'm just shy?

• If I get treatment for the other diagnoses, how will that impact my autistic traits?

If I have done a basic just-look-for-autism assessment, it is unlikely that I'll be able to answer those questions. My responses will run along the lines of - "you would need a comprehensive assessment to know" or "it would be best for you to explore that with your treating clinician."

This is where the beauty of therapeutic assessment can play a vital part. Instead of ending with your questions, we start with them and then work together to find the answers.

It's sort of like a movie where you're the lead character and you're on a quest to find the Widget. You come and hire me as a consultant because I'm an expert on Widgets and an expert on all the places where we can find Widgets. Together we explore the high seas/mountain ridges/crevasses being guided by your purpose and goal.

Hmm... let me bring this back to autism!

In the "autism quest," we are co-discoverers. I contribute my knowledge and expertise about autism and psychology and how it all fits together, and you contribute your knowledge and expertise about you, your experiences, and what is important to you.

So, the gist of all of this is that if your only goal is to know whether or not you're autistic, we can absolutely do a straightforward traditional assessment and I would be honored to help you with that. However, if you also want to know how autism fits into the rest of your life and you have a lot of questions about the past, present, and future, a therapeutic assessment might be a better call. You can learn more about the differences between traditional and therapeutic assessments here.

My last plug for the therapeutic assessment of autism is that I think that a therapeutic assessment is well-suited for autistic people. Here are some reasons:

• Less pressure on you to be "correct" during the assessment. Because this is a comprehensive assessment using multiple data sources (history, self-perception, objective data, clinical interview, analysis), there is less pressure on you to “succeed” on any one section because no matter how you do, a comprehensive picture will begin to emerge even if you’ve messed something up (“I don’t know why I told you that I have an addictive personality!”).

• Immediate gratification. Because of the transparent and collaborative nature of therapeutic assessment, you start to learn test findings immediately and do not have to anxiously wait for a big dump of information at the end. You also don’t have to worry about what the psychologist is thinking because I will share my thoughts and hypotheses with you as we proceed forward.

• Kick-start changes to your self-perceptions. Because the learnings start early in the therapeutic assessment process, you begin to reconsider all of those old self-judgments and self-criticisms and feel more optimistic about the future and your potential.

• Self-empowerment. For many of us, when we are engaged with the healthcare industry, we do not feel empowered. Providers tell us what's wrong with us and tell us what we should do - or the opposite, they ask us to make decisions but do not give us the information we need in order to make those decisions. In a therapeutic assessment, you are empowered as a collaborator, co-writer, and co-interpreter throughout the process. For many people, this is a new experience and builds confidence that you can actively move your own life in a desired direction.