During the UK academic breaks, Rory Lees-Oakes and Ken Kelly produce occasional special editions of the Counselling Tutor Podcast, in which they provide a 'deep dive' into a specific topic important to counselling and psychotherapy. In this episode, Rory talks with Angela Maughan about her experiences with autism as both a counselling client and student counsellor. Angela also offers helpful information and insights to remember when counselling clients with autism. Angela was diagnosed as having autism in her early 30s, and has a son who is autistic. Prior to her diagnosis, she experienced a range of mental-health services, including counselling. She is now training to be a counsellor herself, with the aim of counselling autistic teenagers and adults. She runs a support group for people with autism in Gateshead in the UK. Members of our Facebook group - which includes over 20,000 people (students, tutors and qualified counsellors) interested in the world of counselling and psychotherapy - were given the opportunity to suggest questions that Rory would put to Angela. These show-notes summarise the points covered in the discussion on counselling clients with autism and are not a full transcript; please listen to the podcast itself to hear the detailed version. Counselling Clients with Autism: Q & A Summary A: Different people prefer different ways. Personally, I say that I have autism, but some people prefer to say that they are autistic. It is very much a personal preference - so please always ask the individual person about the language they would prefer you to use in referring to their autism. Taking the time to do this can really help to build rapport at the start of the counselling relationship. A: Autism is a neurodevelopmental disorder: this means that our brains are wired differently from those of people who are neurotypical. It can be very stressful to live with autism - everyday tasks that may seem easy for a neurotypical person often feel overwhelmingly complex for someone with autism. It can affect our cognitive and executive functioning, meaning that we forget things and are more prone to accidents. Because this can be really challenging, we are often good at masking our struggles - but this also involves a lot of extra effort and so can be really exhausting. A: Most of my counselling was before I was diagnosed as having autism. I had been serially labelled with a range of other conditions, which led to me experiencing anxiety and low self-esteem. In fact, these are common comorbidities of autism - as are ADHD [attention deficit hyperactivity disorder], OCD [obsessive compulsive disorder], PTSD [post-traumatic stress disorder], epilepsy, pathological demand avoidance, chronic fatigue syndrome and fibromyalgia. As well as epilepsy, PTSD and fibromyalgia, I myself also have migraine. Many of these conditions relate to the sensory overload and exhaustion that come with living with autism. A: I have had a range of types of counselling and counsellors, each with its own strengths but also frustrations. CBT [cognitive behavioural therapy] was particularly frustrating - many people with autism struggle with the homework tasks for this. This can lead to more anxiety - and I even had letters sent to my doctor by the therapist saying that I was being non-compliant. I have also struggled with talking therapies when a phrase used is ambiguous (it takes a lot of effort for me to work out what the therapist means) - and when silence is used (it made me feel awkward and panicky, and so overwhelmed). A: The most important thing is to build rapport. Take the time to get to understand about their autism, how it affects them, what they need and what to do if they reach crisis point in the session. Be open to the idea of using forms of communication other than words - for example, offer the opportunity to draw as a way of expressing emotions.