Crisis Services
ASERT does not offer crisis services through our Resource Center. If you or someone you love is experiencing mental health distress or thoughts of suicide please call or text 988 for support.
ASERT does not offer crisis services through our Resource Center. If you or someone you love is experiencing mental health distress or thoughts of suicide please call or text 988 for support.
These resources focus on different aspects of Person-Centered planning, and include take away points and lessons learned from various ASERT projects over the years. Topics include: self-advocacy, case conceptualization and using data visualizations (graphs).
Self-advocacy can be a challenge for individuals with autism because it requires social initiation and social interaction, as well as perspective taking and effective communication skills. However, all of these skills can be mastered with practice!Autism is considered an “invisible disability” meaning that you can’t tell that a person has a disability just by looking at them. For individuals with invisible disabilities, the ability to self-advocate is very important, because it’s less likely people will automatically offer accommodations or modifications. Individuals must speak up for themselves to explain and ask for what they need.
Generally speaking, self-advocacy means:
So that individuals have the knowledge necessary to succeed and are given the chance to participate in decisions that are being made about their life. Self-advocacy involves:
In order to effectively self-advocate, an individual needs to know themselves well. This includes knowing areas of strengths and weaknesses, as well as accommodations to help them be successful.
Requests for accommodations will be more successful if individuals consider the perspectives of others and the overall environment or situation. For example, if music is playing loudly in a restaurant, request a quieter area to sit, rather than ask for all the music to be turned off.
It’s important for a self-advocate to know what accommodations they need to be successful. Understanding what reasonable accommodations would be most beneficial to them is important for a self-advocate.
People may be more willing to cooperate, if they have an understanding about why the request is being made. Noting some specific things that interfere with or enhance success, can avoid confusion and increase understanding.
In the 2011 Pennsylvania Autism Needs Assessment, 85% of individuals with Autism Spectrum Disorder (ASD) reported having a co-occurring mental health disorder. Having anxiety and/or depression along with ASD is the rule rather than the exception. Various issues bring people to treatment, but they are often only the tip of the iceberg. When people seek therapy for issues in their lives, therapists often first answering the what. John is a 20-year-old with ASD, anxiety,
and depression. However, that is only the first step in treatment; what we are often more interested in is the why. Why does John have difficulty making friends? Why does he lose his temper so easily? Why does John not want to leave his room? Why does John seem sad all the time?
The issues that people bring to therapy can be thought of as ingredients that are in search of a recipe. The case conceptualization is the recipe; it is the story of why we do what we do. Often times, therapists have several places they can start in therapy: Which issue does the individual list as the most important for them to change? Which issue interferes most with this person’s quality of life? Should I treat multiple issues one at a time or all at once? If I chose to start with one, is there a particular order that I should go in?
A good case conceptualization will answer these questions and provide a road map for treatment. The following are the steps to complete a case conceptualization:
Collect information from multiple sources: clinical interviews, self- and other-report questionnaires, self-monitoring data (e.g., daily behavior or mood tracking), and reports from family members and other treatment providers.
Develop a comprehensive list of and triggers for the current presenting problems.
Draft working hypotheses about reasons as to why this issues are happening using a specific theory (e.g., ABA, cognitive behavioral) and then personalize the hypotheses using the experiences of that particular person.
Start interventions guided by hypotheses.
Monitor – are things changing as expected?
Revise hypotheses as needed
Case conceptualizations can either be written out as a narrative in as little as a one to two paragraphs or can be visualized in a chart. It is important to be collaborative and person centered throughout this process relaying on the individual’s input about what is important and how things may be interrelated. Sharing a case conceptualization with a client can be a powerful therapeutic tool and can be adapted for all levels of ASD and intellectual impairment.
Being a therapist is being a scientist; we must follow the scientific method to guide treatment. When therapists feel as if they do not know what to do next or feel as if they are chasing symptoms and the newest crisis, these are signs of needing to revisit the case conceptualization.
For more information on case conceptualizations using a cognitive-behavioral framework, see Friedberg et al. (2009), Friedberg & McClure (2002), Kuyken, Padesky, & Dudley (2009), Persons (2008), and Beck (1995).
Presenting problem: irritability and verbal aggression in 20-year-old male with ASD
Data from multiple sources: moderate ASD, moderate irritability, severe social anxiety and depression, low motivation, low community participation in important activities
Problem list includes: moderate ASD, anger, social anxiety, depression, increased daytime sleeping, no same-age friendships/romantic relationships
Triggers: drastic decrease in community involvement following high school graduation, loss of BHRS services, closest friend recently moved out of state, recent family stressors
Data is easier to interpret when put into a visual form where multiple data points can be summarized and relationships and trends can be easily determined. When designing a visualization strategy, remember that the goal is to make the message more apparent.
Consider this example: One of Joe’s goals is to increase time in the community, so his team tracks the number of trips he takes in the community.
Visualizing the data readily allows the team to see that there is an increasing trend of community outings as the week progresses with Mondays being the low point and Saturdays being the high point. This trend is not apparent from a data table.
In general, less is more for data visualizations as it makes them easier to understand and interpret. Including too many variables on one graph can make things complicated and difficult to understand. The aim is to include as much information as you can , while keeping the design as simple as possible.
Joe and his team decide the amount of time he spends in the community each day is as important as the number of trips he takes. The previous line graph does not show how much time he was in the community, only the number of trips. You could create a second graph that showed the number of minutes he was in the community each day, or find a way to incorporate both factors into one graph.
By switching to a bar graph the team can graph the number of trips on the horizontal axis and color code the bars to represent the amount of time he spends in the community. Now two points of data are being represented, allowing the team to evaluate his community outings more effectively. For example, as a result of this data visualization, Joe and his team may decide to revise his community plan for Sundays, as four outings occur but he is spending less than 60 minutes in the community. Mondays are also a concern as he’s only gone into the community once on those days and for less than an hour. On the opposite side,the team may want to look more closely at Thursdays as he’s only gone out twice those days, but is in the community for more than 2 hours. There may be opportunities there that can be used to increase his access to activities on other days.
Name | Description | Type | File |
---|---|---|---|
Person-Centered Planning | Self-Advocacy | Download file: Person-Centered Planning | |
Person-Centered Planning | Helping Others Self Advocate | Download file: Person-Centered Planning | |
Person-Centered Planning | Case Conceptualization | Download file: Person-Centered Planning | |
Person-Centered Planning | Creating Effective Data Visualizations | Download file: Person-Centered Planning |
This information was developed by the Autism Services, Education, Resources, and Training Collaborative (ASERT). For more information, please contact ASERT at 877-231-4244 or info@PAautism.org. ASERT is funded by the Bureau of Supports for Autism and Special Populations, PA Department of Human Services.