Cognitive-Behavioral Therapy for Adult Asperger Syndrome » (New Edition)

Valerie L. Gaus, PhD, has been a practicing cognitive-behavioral therapist serving adults and adolescents with dual diagnosis (intellectual disability with comorbid psychiatric disorder), autism spectrum disorders, mood disorders, and anxiety disorders since she received her doctorate in clinical psychology from Stony Brook University in 1992. Since then she has maintained a private practice on Long Island, New York, and serves as the staff psychologist for the Vincent Smith School in Port Washington, New York. Dr. Gaus is on the advisory board of the Asperger Syndrome and High Functioning Autism Association, the grant review committee of the Organization for Autism Research, and the adjunct faculty at Long Island University/C. W. Post. She was also a founding board member of the New York Metro chapter of the National Association for the Dually Diagnosed. Dr. Gaus has written numerous articles and book chapters on mental health issues in developmental disabilities and has lectured extensively on these topics across the United States and abroad.

An invaluable resource for therapists, this lucidly written book provides research-based strategies for addressing the core problems of Asperger syndrome (AS) and helping clients manage frequently encountered comorbidities, such as anxiety disorders and depression. Detailed case examples illustrate the complexities of AS and the challenges it presents in daily life, relationships, and the workplace. The author presents a cogent rationale for cognitive-behavioral intervention and offers clear guidelines for conducting assessments and designing and implementing individualized treatment plans. Throughout, the emphasis is on helping people with AS decrease distress while preserving and building on their unique strengths. Special features include a case formulation worksheet and other helpful reproducibles.

PsychCentral.com

"Valerie Gaus has made a major contribution....She provides a practical overview of diagnostic cues as well as guidelines for evidence-based therapy....She has developed a comprehensive and effective model for intervening with adults with AS. Using case studies from her many years of research and practice, she offers the practicing clinician a readable and helpful window into work with this challenging population....Gaus'' frequent use of transcriptions of parts of sessions, anecdotes, and multiple case examples illustrate her ideas and keep us engaged....A readable and fascinating journey into the lives of those with AS and an opportunity to see an expert clinician at work. While it is targeted to the practicing mental health clinician, the book would also be helpful to others who work with and relate to people with AS, including co-workers and supervisors, family members, and romantic partners. Clients with AS who are distrustful of authority or who are discouraged about therapy may find it an encouraging and exceptionally practical means of self-help."--PsychCentral.com

Introduction     1
The Book's Intended Audience     1
Terminology     2
Mental Health Needs of Adults with Asperger Syndrome     3
Removing Barriers and Bridging Gaps     4
Origins of My Ideas     4
A Philosophy of Change     11
Defining Asperger Syndrome in Adulthood     13
What Is Asperger Syndrome?     13
How Does Asperger Syndrome Present in Adulthood?     15
Understanding the Symptom Picture in Adults with Asperger Syndrome     28
Strengths and Assets     36
Chapter Summary and Conclusions     38
Conceptualization of Mental Health Problems in Adult Asperger Syndrome     39
General Conceptual Model     39
Core Cognitive Dysfunction in Asperger Syndrome     43
Cognitive Dysfunction and Risk for Mental Health Problems     60
CBT for Asperger Syndrome     65
Chapter Summary and Conclusions     66
The Initial Assessment     67
Intake Issues     67
Diagnosis and Definition of Target Problems     79
Chapter Summary and Conclusions     96
Individualized Case Formulation and Treatment Plan     99
Case Formulation     99
Treatment Plan     109
Chapter Summary and Conclusions     119
Psychoeducation and Orientation to Treatment     120
Psychoeducation     120
Orientation to Treatment     124
Chapter Summary and Conclusions     131
Intervention: Increasing Skills to Address the Core Problems of Asperger Syndrome     132
Review of Nomothetic Formulation     132
"Habilitation" for Core Problems     133
Increasing Social Skills     135
Increasing Coping Skills     152
Chapter Summary and Conclusions     161
Intervention: Addressing Comorbid Mental Health Problems     162
Introducing the Cognitive Model to the Patient     164
Identifying and Responding to Dysfunctional Automatic Thoughts     169
Recognizing and Modifying Intermediate Beliefs     177
Modifying Schemas     186
Chapter Summary and Conclusions     192
Adjunctive Therapies and Interdisciplinary Collaboration     194
Guidelines for Referral and Collaboration with Other Service Providers     194
Adjunctive Services and Their Roles     196
Chapter Summary and Conclusions     203
Obstacles to Treatment and How to Address Them      204
Social Interaction Difficulties as Challenges in the Psychotherapy Session     204
Executive Function Problems Interfering with Homework Completion     207
Low Motivation to Be in Treatment or Rejection of the Cognitive Model     208
Family Issues That Interfere with Treatment     208
Substance Abuse     209
Isolation and Lack of Supports     210
Financial Problems     210
Untreated Health Problems     212
Polypharmacy: Multiple Psychiatric Medications without a Rationale     213
Lack of Cooperation from Other Providers     213
Chapter Summary and Conclusions     214
Ending Treatment and Looking Ahead     215
When the Goals of Treatment Are Met     215
When Treatment Is Interrupted before Goals Are Met     217
Looking Ahead for Adults with Asperger Syndrome     220
Concluding Comments     222
Therapy Resources     223
References     227
Index     237