Dialectical Behavior Therapy (DBT) is a powerful therapeutic approach, but its traditional structure may not always align seamlessly with the unique needs of neurodivergent individuals, especially autistic adults. In this post, we explore adaptations to DBT skills and groups that prioritize neurodivergence, ensuring accessibility and resonance for autistic participants. These considerations can also be useful for individuals to adapt DBT skills in self management, as well as for therapists working with autistic clients individually who are integrating DBT skills into their therapy.
A factor that is more important than any individual skill adaptation though, is the genuine motivation for the therapist/group facilitator/skills trainer to understand the person/people they’re working with. It’s common for sensory and social needs to differ for an autistic adult depending on a lot of factors. Factors that may change someone’s tolerance and needs on a particular day include: how they’ve slept, how they’ve been eating, if they’re unwell, if they’ve had socially demanding tasks recently, if hormone changes have impacted their mood and sensitivity, as well as their feeling of safety in the individual or group therapy setting. This approach to therapy can then inform all other changes that are made and ensures the client is at the centre of the process.
As the saying goes: “if you’ve met one autistic person, you’ve met one autistic person”. Don’t assume needs or preferences for someone based on another autistic person you’ve met.
1. Sensory Aversions and Seekings: Navigating the Sensory Landscape
Understanding and accommodating sensory aversions and sensory seeking patterns are paramount in adapting DBT for autistic adults. Tailoring mindfulness exercises to account for sensory preferences, providing sensory-friendly spaces during group sessions, and incorporating grounding techniques that resonate with neurodivergent sensory experiences contribute to a more inclusive environment.
During individual or group therapy intake discussions, it’s important to ask about sensory needs to make the person as comfortable as they can be. This shows respect to the person, helps start to build a relationship with them, as well as minimising or preventing difficulties later down the track that might get in the way of effective therapy.
2. Neurodivergent Burnout: A Recognized Challenge
Neurodivergent burnout is a prevalent concern often overlooked in traditional DBT settings. Adapting mindfulness practices to acknowledge and address the unique stressors leading to burnout, incorporating self-care strategies that align with neurodivergent needs, and fostering a supportive community within the DBT group can mitigate the impact of burnout on autistic participants.
3. Managing Meltdowns and Shutdowns: Practical Approaches
Traditional DBT may not explicitly address the management and prevention of meltdowns and shutdowns, critical aspects for autistic individuals. Integrating emotion regulation skills that specifically target sensory overload, creating personalized crisis plans, and normalizing the experience of meltdowns/shutdowns within the group dynamic contribute to a more accommodating and understanding environment.
4. Communication: Embracing Neurodivergent Styles
Recognizing that there is no one-size-fits-all approach to communication is crucial in adapting DBT for autistic adults. Encouraging alternative communication methods, understanding non-verbal cues, and respecting diverse communication styles foster an inclusive and accepting atmosphere within the DBT group, promoting a sense of validation for neurodivergent participants.
In adapting DBT skills and groups for autistic adults, the journey involves embracing neurodiversity, recognizing individual needs, and fostering an inclusive and supportive community. These adaptations not only enhance the effectiveness of DBT for neurodivergent individuals but also contribute to a more affirming and accessible therapeutic experience.
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