Therapy For Teens With Asperger's

Teens With Asperger’s Worry About The Typical Teen Stuff, But This Doesn’t Mean Therapy Should Be Formulaic

Teens with Asperger’s are teenagers. They’ve got all the usual stuff on their minds that most, if not all teenagers have–school, dating, sex, friends, sexual and gender identity, college, etc. Often teens with Asperger’s are worried about social issues and dating, while their parents worry about their transition into college and adulthood.

It’s also the case that every teen with Asperger’s is different. As therapists who work with teens with Asperger’s, we don’t work with a formula. What’s most important in our therapy practice is that we sit with teens and their parents to make sense of what is important to them.

Teens With Asperger’s Should Be Involved In Selecting And Shaping Their Therapy

Teens with Asperger’s have had many choices made for them over the course of their lives. While this is true for all teens (being a child means parents and others make choices for you), teens with Asperger’s have simply had many more decisions that have needed to be made on their behalf. Likewise, teens with Asperger’s have typically logged thousands of hours of therapies–psychiatrists, speech therapists, occupational therapists and generally lots of psychotherapy.

In adolescence, teens should be involved in selecting the therapist and articulating what they want out of treatment. When we are approached by parents of teens with Asperger’s, who are considering therapy, we work to establish, from the beginning, a sense of this as a new start–one in which the teen is empowered to be more active in shaping their therapy.

What’s specific to an Asperger’s diagnosis is that communication and expression are atypical, by the very nature of the condition. Therefore, teens with Asperger’s wishes are often misinterpreted or unappreciated. Their opinions–or the idea that they have opinions–can be hard to see. When working with teens with Asperger’s, we want to start therapy on the right footing, by engaging this very issue.

We Help Teens Understand What Having Asperger’s Means To Them

Asperger’s is a scary word. It’s hard to pronounce and multi-syllabic. It’s a word that conveys a broad variety of experiences of being in the world. Helping a teen understand what it means to have Asperger’s is as much about learning about that teen’s individual experience as it is about telling them how the diagnosis works. This doesn’t mean understanding the nature of Asperger’s, grounded in our experience of working with teens (and adults) with the diagnosis, is any less important.

In our therapy with teens with Asperger’s, we listen to young people and talk to them about how they see themselves, how they experience how others see them in the world, what their parents and others have told them about who they are, how they see their future and whether it involves college or something else. We talk about the word Asperger’s and the ways it can feel scary. In a sense, we help guide teens to a point in which they can claim ownership of their own understanding of this word that was assigned to them. This can also include a teen choosing to reject the word.  

In the past fifteen years or so, there’s been something of a movement toward embracing Asperger’s as a positive expression of identity. In some ways, this movement has paralleled and borrowed from some of the post-identity movement related to gender expression, which eschews labels in favor of an appreciation of difference that exists on a spectrum (if systematizable at all). What’s cool here is that teens can be free to create their own meaning of who they are and how they relate in the world. None of this is meant to downplay the challenges that often come in the realm of Asperger’s, but teens are encouraged to figure out what the diagnosis means to them.

Navigating Social Issues For Teens With Asperger’s

In our therapy practice for teens with Asperger’s, teens are, like most teenagers, especially concerned about social issues like making friends and dating. However, by definition, Asperger’s is understood to come with challenges in social interactions. Interpreting so-called social cues, trying too hard to get people to like them, not knowing when enough is enough, dealing with nerves related to socialization and overcoming a history of difficult social interactions are all situations we see teens with Asperger’s struggling with.

For many with Asperger’s, these limitations are relatively minor. For others, the concern is one that demands a good deal of planning. How do we, as therapists, help? In short, a great therapist is an ally. The trick is knowing how to get teens with Asperger’s to talk–about what they like (and who they like), about what they’re afraid of and what they want but are afraid to go after.

And This Includes Dating And Sex

Dating comes with all these same challenges, plus the added dimension of sex and, in most cases, getting close to someone of the opposite sex. With dating, we ask teens with Asperger’s: What feels safe? What feels good? What doesn’t? How do you tell if your partner is into it?

Often teens with Asperger’s need to learn how to ask and how to talk through things. Teens with Asperger’s can need coaching on understanding different kinds of yes’s (and no’s and maybe’s), sorting out how to tell the difference between a friend and a romantic interest and how to express their own feelings of such. With dating and sex, it’s important to be explicit, erring on the side of over-communicating.

Sometimes teens with Asperger’s benefit from “rules”–not the sort of rules that are imposed from the outside (though they need those as well), but the sort of rules that can guide them through a tricky situation. Things like asking before hugging or kissing (or any sexual activity) in situations where others might be able to read cues and feel their way through can be especially helpful to teens with Asperger’s.

Teens With Asperger’s Can Need Support Managing Anger

A lot of kids with Asperger’s are angry. The world is mostly built by and for people who don’t have Asperger’s. This can make things difficult, including certain academic tasks, social tasks and dealing with emotions. They are also frequently dealing with their parents worrying about them.

This anger can look either like, well, anger, or it can manifest as a more buried, pleasing-everyone anger. Therapy can give teens with Asperger’s a place to put their anger and better understand it. We help teens with Asperger’s find ways of naming their anger, rather than acting reactively to it. Teens can, then, address the things that are happening in their lives that they are angry about (as in solving the problem itself).

For Parents Of Teens With Asperger’s, Seek To Build Influence

Often with little kids, especially when they struggle to make sense of social cues and norms like kids with Asperger’s, there is a need for parents to lay down the law. Authoritarian, imposed-by-parents rules is the norm in our culture, even when collaborative, influence-based parenting is what is needed. This is especially true for kids with Asperger’s. As kids approach adulthood (i.e. in their teens), there’s only so much time left for the opportunity to influence at all, through whatever means. Authority has an expiration date–at some point, your child is going to be 22 or 26 and no amount of demanding or insisting is going to make much of a difference.

To us, the central adage in parenting teens, with or without Asperger’s, is to seek to build influence. How? Be curious. Collaborate (“How should we solve this problem?”). Talk to your teen about the sort of person he or she wants to be. Ask if she or he wants to know what you think before saying it. And yes, of course (for God’s sake, of course!), if your teen is smoking pot in her bedroom or skipping school, lay down the law. But when possible, influence. Create rules together.

We Know Parents Of Teens With Asperger’s Worry About Their Transition Into Independence: We Can Help

In our therapy practice, we often see parents of teens with Asperger’s that are concerned about their transition into adulthood. They wonder: Is college an option? What sorts of limitations may exist for someone with Asperger’s as far as making a living and living independently?

The work that happens in the years leading up to this transition is what is crucial, including parents building influence with their teen. If a teen needs help learning to shop and cook, then they really need a residential program that helps teach them these skills. Therapy can help with the emotional part of their transition into independence.

This is just one reason why it is important for teens with Asperger’s to take ownership of their therapy. The therapy, in this case, really needs to be adult therapy, which means the teen has a say in how the therapy is structured. By encouraging the teen to direct how often we meet, what we talk about and whether parents are involved (or not), based on the teen’s desire for them to be in the therapy room (or not), we support teens with Asperger’s to be more empowered to shape their lives as they move toward independence.