Autists For Change

Autists For Change does not provide medical advice. We are simply recommending what we believe in, not what is always right for you. Trust your doctor’s and your own judgement.

Many autists, including myself, have shown their dislike towards ABA therapy. However, many people have no idea where to start when finding a better alternative for ABA. Today, we are going to go into some ethical alternatives to ABA, why I prefer them, and the downsides to each of them. Of course, in this ever changing landscape there will be some alternatives I miss, and changes to the ones I have picked, so I will try to keep this all updated. Remember, everyone with autism is different, and many of these won’t work for you. Maybe even ABA works for you. I would highly recommend to not use ABA unless it is your last resort. With that being said, let’s get into the list.

CBT(Cognitive Behavior Therapy)

CBT, or cognitive behavior therapy, is one of, if not the most common alternatives to ABA. I’m not saying it’s the best, as there are also controversies surrounding CBT, I’m just saying it is better than ABA. That said, ABA is a low bar to clear, at least to many people. Here is a quick overview of CBT and what it does.

CBT is used to treat a wide range of things. Ranging from autism to chronic pain, it can help people support and cope with conditions.¹ CBT is a type of psychotherapy, meaning you work with a therapist to talk it out. In CBT, the therapist helps you change how you think, to avoid negative thoughts. Together with your therapist, you will learn to recognize “problematic” thoughts and behaviors, figure out what causes them, and then learn to adjust your thoughts and behaviors to avoid and eliminate those “problematic” thoughts and behaviors. ² Often, there will be “homework” which can be time consuming, and can include writing down problematic thoughts, and trying to eliminate them farther down the line. Timelines mostly range between 5-20 weeks.

There are some controversies surrounding CBT as well, which makes me hesitate to recommend CBT. Some of these include the fact that the person who is in CBT has some, but not much, input on what goes on. The therapists choose what is “problematic”, which can often be different from what the person thinks is problematic. CBT also doesn’t always focus on the root cause of the thoughts or actions, instead it just focuses on the thought or action.³ This can often lead to relapses, and causes CBT to be a temporary solution. Also, as some people put it, CBT is based on gaslighting.

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OT/PT(Occupational Therapy and Physical Therapy)

Occupational therapy and physical therapy are 2 different therapies, that both are sometimes used for people with autism. I am doing them together because they are fairly similar. Both teach skills, that can be applied into the real world, more so than ABA. OT and PT doesn’t focus on changing problem behaviors like ABA does, instead they help improve skills that are needed for everyday life. The difference between PT and OT is that OT teaches skills, while PT helps increase mobility and strength.

Occupational Therapy

Occupational therapy is tailored to a person’s needs, so that they can learn skills applicable to their life in the world. Depending on the patient, the skills taught can range wildly, from things like getting dressed, to things like driving⁴. For children, OT is often given in schools, and often focus on helping them learn, have fun, and thrive at school. Occupational therapy is used with people with many different conditions, many of them physical. It is often used with autism, as autism is considered a development disorder. In OT, a therapist will look at your needs, medical history, etc, to figure out what goals to set and skills are needed to be learned. The length of treatment can vary from a few sessions over a few weeks, to several months worth of sessions.

When you are in OT, your plan will often include doing things during the day while not in sessions. This can help you improve skills in the setting that is most applicable to you. The “occupations” of occupational therapy, are things that people do and want to do to support their daily life. These can include(but are not limited to): working/going to school, driving, self-care, making/eating meals, managing medications, and more. Overall, the goal of OT is to help you regain/maintain independence, and help you effectively perform day-to-day tasks⁵.

Physical Therapy

Physical therapy is used for people with autism to help them gain mobility and strength. Because autism is considered a developmental disorder, PT can help with the development of muscles and coordination. PT is used in cases where gross motor and fine motor skills are lacking, and that often comes with a side of low muscle tone⁶. Autism is not PT’s main use case, but it can certainly help autists gain some strength and mobility that they didn’t have before. One thing to note about both PT and OT is that they can teach skills that can make someone with autism seem more normal. This, in my opinion, isn’t as big of a deal compared to ABA just because ABA seems to “mask” stereotypical autistic actions. Instead, OT and PT teach skills that can help autists live a better life, and they don’t try to eliminate stereotypical actions by autists.

In physical therapy for autism, you work with a physical therapist, often in school if you are a child, or in an office. When you have physical therapy, you do exercises and stretches to gain strength and mobility. In your first session, you will go over your medical history and get a physical done, so that the therapists know exactly what to do. PT isn’t the most used therapy for autism, and for good reason. It can definitely help, don’t get me wrong, but it should be used in association with other therapies.

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Humanistic Approaches to Therapy

What does it mean when you say a “humanistic” approach to a therapy? Well, a humanistic approach is where a therapist gets to know and understand their client. I am biased towards this, because it works really well for me, and I think it can help a lot of autists understand and improve their day-to-day lives. The therapist understands you, and, instead of looking at the past, they aim to improve the present. A big part about humanistic therapies, and humanistic approaches to other types of therapy, is that you open up to the therapist and truly trust them. They also have to learn about you, and how to understand you, to help get more personable with you. In my therapy, for example, I talk with my therapist about the problems of my week, as well as all the projects I’ve been working on, and other interesting things about my life. We’re not exactly friends, as I’m still his client, but he interacts with me as though we are friendly.

A humanistic approach can be applied to many therapies on this list, and maybe even ABA(could certainly improve it). Some of humanistic therapy’s other traits include a lot of listening, and a lack of judgement by the therapist. In most humanistic therapies, the client leads the way with their feelings and ideas, and the therapist accepts it.⁷The main ideas that are applied in humanistic approaches for other types of therapies(like creative arts therapies) is that there is a good client-therapist relationship, in which the therapist understands and acknowledges the client, and that there is total acceptance.

For instance, a humanistic approach to something like creative arts therapy, something else that I have been through, would go like this, at least at my school(I have music therapy). I get pulled out of class to go to the music therapy room, and on the way my therapist, we’ll call her Sheila, talks to me a little bit. She checks up on how I’m feeling, and things more personal, like how my cats are doing. Some days we do mostly music, learning things and listening to it. Some days she can tell that I’m feeling bad or something was wrong, and those are the days where we start to discuss other things. Those things include what’s going on at school, what I need at school, and she listens and accepts what I say. Sometimes we start to discuss solutions to problems that I bring up. The discussions are often baked into music, and it works well for me. This is just my experience, and it might not be yours, but Sheila helps me figure out what I need to do.

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Creative Arts Therapies

There is a whole list of creative arts therapies. Creative arts therapies are great for helping autists do creative things while also managing their stress and anxiety. I consider myself a creative, with videos and music, as well as this website, so creative arts therapies help me improve my creative skills, while learning to manage and express emotions, through artistic expression and creation. Creative arts therapies can also improve cognitive functions, enhance social skills, and many other things, depending on the creative arts that you do in your therapy. ⁸Without further ado, let’s get into the list of creative arts therapies.

Music Therapy

Music therapy is a creative art therapy that I receive through my school. Music therapists often teach clients to play music, sing, and write music. Music therapy can benefit autists in many different aspects of life, whether it be mental, social, emotional, or physical. Music therapy is different from using music therapeutically. Using music therapeutically means to listen to music to relax, and it isn’t a therapy. In music therapy, you listen to or make music, and use music as an outlet for your emotions, and help you feel better.⁹ It can help lessen stress and anxiety, improve relaxation, communication, social, and emotional skills, and can even help you improve your motor skills, by playing an instrument. Before going into music therapy, you will discuss your needs and strengths with your therapist, but once that happens, there isn’t much risk in music therapy(other than a rick roll), and there are significant benefits associated with it.

Art Therapy

Art therapy, another creative way to let out stress and anxiety. The goal of art therapy is to use the creative and artistic process to explore yourself, and find coping skills, and improve yourself. Many types of the more fine arts are done in art therapy, including drawing, painting, sculpting, and more¹⁰. Art therapists don’t just do art, however, as they are still therapists. They help people process emotions, express thoughts, and recover from experiences that may be traumatizing. In art therapy, you may create art, with or without the help of the therapist, go over it’s meaning, and discuss what thoughts and feelings it provokes in you. As in most therapies, you spend the first session going over what you need, and possibly getting more specific details about your therapy. There are small risks of triggers, as in any therapy, but the benefits mostly outweigh the chances of triggers, and I would recommend it. Also, for all of these, you don’t have to be creative to do them, these therapies will go to your level.

Dance/Movement Therapy

Dance therapy, or DMT is a great way to build up self-confidence and get out emotions in a way that feels productive. DMT is used to improve emotional, social, mental, and physical connection. The goal of DMT is to use dance to improve coping and other skills, manage emotions in a safe way, and learn to better express yourself¹¹. In DMT, a therapist may help you understand emotions through motion, track breath and sensations, guide your movements, and help you process emotions that may come up. There are some risks, like sudden triggers, possible falls and physical injuries, and just not feeling in place at these therapies. However, there are benefits, like promoting calm, building self awareness, and teaching coping skills. It may not be for you, but it certainly can be an option if dancing is something you are interested in.

Drama Therapy

Another great creative arts therapy is drama therapy. Drama therapy uses theater techniques like acting, improv, role playing, and more, to achieve therapeutic goals. Overarching goals in most drama therapy sessions are to achieve personal growth and self awareness, improve social skills, connect your emotional and physical health, and improve overall quality of life¹². Drama therapists sometimes work with groups of people at a time, to improve social skills and to use more advanced theater techniques. In drama therapy, you do drama, and do talking in order to understand and cope with your emotions and traumas. There are always risks in therapy, like bringing up unexplored traumas that can be triggering, but it has been found effective as a therapy.

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1. https://www.mayoclinic.org/tests-procedures/cognitive-behavioral-therapy/about/pac-20384610 ↩︎
2. https://my.clevelandclinic.org/health/treatments/21208-cognitive-behavioral-therapy-cbt ↩︎
3. https://community.counseling.org/blogs/david-metzner1/2021/03/01/limitations-of-cbt ↩︎
4. https://www.healthline.com/health/occupational-therapy#what-to-expect ↩︎
5. https://www.medicalnewstoday.com/articles/what-is-occupational-therapy#what-do-o-ts-do ↩︎
6. https://www.verywellhealth.com/physical-therapy-as-a-treatment-for-autism-260052 ↩︎
7. https://www.healthline.com/health/humanistic-therapy ↩︎
8. https://www.medicalnewstoday.com/articles/creative-therapy#what-is-it ↩︎
9. https://my.clevelandclinic.org/health/treatments/8817-music-therapy ↩︎
10. https://www.verywellmind.com/what-is-art-therapy-2795755 ↩︎
11. https://psychcentral.com/health/dance-therapy#benefits ↩︎
12. https://www.goodtherapy.org/learn-about-therapy/types/drama-therapy ↩︎