Journal of Contemporary Psychotherapy - Understanding and Treating Clients with Autism Spectrum Disorders

vendredi 2 décembre 2011

Le numéro de mars 2011 du Journal of Contemporary Psychotherapy est consacré à la compréhension et au traitement des personnes avec autisme.

Les articles sont consultables sur le site de l’éditeur.

1. El-Ghoroury N, Krackow E. A Developmental–Behavioral Approach to Outpatient Psychotherapy with Children with Autism Spectrum Disorders. Journal of Contemporary Psychotherapy ;2011 ;41(1):11-17.

Over the course of development, children with autism spectrum disorders (ASDs) may present with an array of behavioral symptoms in addition to the primary impairments in language, socialization, and repetitive/restricted interests. These developmental challenges allow outpatient psychotherapists the opportunity to provide helpful clinical services to children and adolescents with ASDs. This can be best accomplished by combining behavioral strategies that are typically effective with children with ASDs with evidence-based approaches helpful for other psychiatric conditions. Four case examples are provided that review how to use both ASDs and general child clinical interventions with children with ASDs and their families.

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2. Ferraioli S, Harris S. Effective Educational Inclusion of Students on the Autism Spectrum. Journal of Contemporary Psychotherapy ;2011 ;41(1):19-28.

Beginning with early efforts to prepare preschool aged children with autism to join their peers in regular education classes, there has been a continuing interest in including children with autism spectrum disorders (ASDs) in regular education classes. A modest body of literature has explored ways to enhance the social interactions of children with ASDs and to more fully integrate them into academic and co-curricular experiences with their peers. These efforts have shown benefits to the children with ASDs as well as their peers in specifically defined situations. While there remains a serious lack of rigorous research in this area and a clear need for additional study regarding the long term impact of full inclusion on both groups of children, the existing research provides some interim strategies for professionals working with these children.

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3. Gaus V. Adult Asperger Syndrome and the Utility of Cognitive-Behavioral Therapy. Journal of Contemporary Psychotherapy ;2011 ;41(1):47-56.

Asperger syndrome (AS) is a developmental disorder that was first recognized in the United States in 1994 with the publication of DSM-IV (American Psychiatric Association, Diagnostic and statistical manual of mental disorders, 1994 ). As a relatively new concept to the United States, both within the professional community and public awareness, the diagnosis has most often applied to children, but there is a large cohort of affected adults who have never been diagnosed or properly treated. Many of these individuals are now seeking treatment for the symptoms of AS and/or comorbid mental health problems (e.g., mood and anxiety disorders). Clinicians are in need of practical and evidence-based interventions to address the problems presented by this growing patient population, but there are few such resources available. This article will present a framework for conceptualizing the mental health needs of adults with AS, using the evidence-based approaches found in the cognitive-behavior therapy (CBT) literature to inform treatment.

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4. Gerhardt P, Lainer I. Addressing the Needs of Adolescents and Adults with Autism : A Crisis on the Horizon. Journal of Contemporary Psychotherapy ;2011 ;41(1):37-45.

The cohort of individuals with autism spectrum disorder (ASD) diagnosed as part of the first wave of what is often referred to as the autism epidemic is rapidly approaching adulthood. This cohort represents only the proverbial tip of the iceberg with some reports noting that 70% of the currently identified individuals with ASD are less than 14-years old. These numbers represent a looming crisis of unprecedented magnitude for adults with autism, their families, and the ill-prepared and underfunded adult service system charged with meeting their needs. A review of the current literature on outcomes for adults with ASD indicates that, independent of current ability levels, the vast majority of adults on the spectrum are either unemployed or underemployed and, further, that large numbers of adults with autism remain without any appropriate services. Many have had inadequate transition programming including little attention to service coordination, minimal direct family involvement and/or absence of treatment based on evidence-based practices. Lastly, issues related to staff and provider recruitment and retention present significant, systemic challenges to the provision of effective services. As such there is a significant and growing need for greater attention to individual needs of adults with ASD if we are provide the opportunity for a positive quality-of-life.

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5. Jensen V, Spannagel S. The Spectrum of Autism Spectrum Disorder : A Spectrum of Needs, Services, and Challenges. Journal of Contemporary Psychotherapy ;2011 ;41(1):1-9.

The dramatic rise in the diagnosis of autism spectrum disorders (ASDs) has resulted in a significant explosion in visibility and a substantial increase in the understanding of this complex group of disorders. Over the last decade, what was once defined only as “autism” has become a spectrum of neurodevelopmental disorders, with variable presentations and levels of impairment that requires an equally broad continuum of care. A wealth of research has not discovered a single “cause” for ASDs, but rather has found a range of genetic/genomic variations that likely play a significant role in the etiology of these disorders. Routine screening for autism is becoming more common, allowing for more timely diagnosis, and hopefully for earlier entry into appropriate and effective treatment. Although there remains no single ‘‘cure’’, there are treatments available that can improve overall functioning and decrease problematic or interfering symptoms across the full spectrum of this disorder. The wide spectrum of ASD presentations complicates treatment planning, with overall ASD severity a factor in determining type, intensity, and duration of interventions and services. This article presents a two-dimensional model of “ASD severity” that considers both the level of specific ASD symptoms/deficits and the level of cognitive resources/limitations as a framework for understanding needs, challenges, and potentially effective interventions for individuals across the ASD spectrum.

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6. Koenig K, Levine M. Psychotherapy for Individuals with Autism Spectrum Disorders. Journal of Contemporary Psychotherapy ;2011 ;41(1):29-36.

Individuals with autism spectrum disorders (ASDs) present unique challenges for psychotherapists. Those with autism, Asperger’s Disorder and pervasive developmental disorder-not otherwise specified (PDD-NOS) show impairments in social communication and social relationships as well as unusual behavioral features that set them apart from peers. Further, individuals affected with autism spectrum disorders may experience anxiety, depression, obsessive–compulsive disorder and other psychiatric symptoms that can be distressing and, at times, disabling. At present, there is limited information regarding evidence-based approaches for addressing either core impairments of ASDs or associated conditions in a psychotherapy setting. Nevertheless, information about how persons with ASD experience their world and learn can provide clues about what interventions might be useful to assist them such that they can reach their fullest potential. From this standpoint, new or modified approaches to therapy can be tested and further refined to provide a more comprehensive understanding of the psychotherapeutic challenges and the most efficacious therapeutic approach to maximize functioning in this population.

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