Unmasking Adult Autistic Burnout: A Clinician’s Guide to Supporting Clients

CPD

Planning Committee Disclosure - No relevant relationships

All members of the PESI, Inc. planning committee have provided disclosures of financial relationships with ineligible organizations and any relevant non-financial relationships prior to planning content for this activity. None of the committee members had relevant financial relationships with ineligible companies or other potentially biasing relationships to disclose to learners.  For speaker disclosures, please see the faculty biography.

Handouts

Faculty

Amy Marschall, PsyD Related seminars and products

Sioux Falls Psychological Services

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Amy Marschall, PsyD, is a licensed clinical psychologist in South Dakota, working primarily with children and adolescents. She is trained in trauma-informed care as well as cognitive behavioral therapy, and in 2017 became certified in trauma-focused cognitive behavioral therapy. In her clinical practice, Dr. Marschall works with survivors of abuse, families in the foster care system, children with incarcerated parents, clients dealing with high-conflict divorce or separation, and those growing up with other chronic stressors and traumas.

Dr. Marschall was diagnosed in adulthood as AuDHD (Autistic and ADHD), which informs her deeply empathetic and lived understanding of neurodivergence.

She is also the author of three professional resources: A Clinician’s Guide to Supporting Autistic Clients, Telemental Health with Kids Toolbox, and Telemental Health with Kids Toolbox, Volume 2. These publications reflect her commitment to providing accessible, neurodiversity-affirming, and trauma-informed tools for clinicians working with children and adolescents in both in-person and virtual settings.

 

Speaker Disclosures:
Financial: Amy Marschall is the founder of Resiliency Mental Health and has employment relationships with RMH Therapy, ADHD Online, Prosper Health, AuDHD Therapists, A Change for Better, A Change for Better Fund, Grayce, and DotDash Meridith. She receives royalties as a published author. Amy Marschall receives a speaking honorarium, recording, and book royalties from PESI, Inc. She has no relevant financial relationships with ineligible organizations.
Non-financial: Amy Marschall is a blogger with Resiliency Mental Health, Psychology Today, DotDash Meridith, and Everyday Health.

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Objectives

1. Analyse current standards of care for autism and the limitations associated with these approaches.
2. Utilise current research around autistic burnout to conceptualise cases.
3. Choose appropriate treatment recommendations to alleviate symptoms of autistic burnout in adults.
4. Modify existing interventions to reflect a neurodiversity-affirming approach to mental health care with autistic adults.
5. Identify 10 evidence-based and neurodiversity-affirming interventions to use with autistic adults experiencing burnout.
6. Formulate neurodiversity-affirming treatment plans with autistic adults experiencing burnout.

Outline

Video Testimonials: Trauma and Harm Caused by the Deficit Model “Treatments”

• Current standards of care, incl. associated limitations, trauma, harm
• The prevalence of trauma symptoms over non-autistics
• Autistics who undergo traditional “treatment” vs. those who do not
• The goals of traditional “treatments”

Neurodiversity-Affirming Care: A Shift Away from “Fixing” to Supporting

• What neurodiversity-affirming is/is not
• Rethinking autism and mental health care
• Affirming and trauma-informed
• Affirming and intersectional
• Centering autistic voices

Video Testimonials: What Autistic Burnout Looks Like in Adults

• Differentiate from other diagnoses
• Screeners, symptoms, warning signs
• Burnout and suicide
• Risk assessments: passive vs active
• Talk to clients about suicide

Neurodiversity-Affirming Interventions to:

Prevent Adult Autistic Burnout

• What’s within the therapist’s and client’s control
• Proactively identify and address unmet needs
• Fight barriers to getting needs met
• Find manageable levels of responsibility
• Help clients unmask safely
• Recognise burnout levels and provide support before escalation

Treat Adult Autistic Burnout

• New and creative sensory safe spaces
• Find alternative communication
• Fidgeting and stimming
• Meet body survival needs
• Teach positive self-talk and self-monitoring skills
• Prevent future burnout episodes
• Accommodations requests

Case Studies: Neurodiversity-Affirming Interventions

Nonbinary Autistic Adult, Age 25

• Graduate student who hit burnout while in school
• Determine what’s manageable and what changes are needed for ongoing well-being
• When a client can no longer use previously effective skills

Autistic Female, Age 19

• Childhood sexual and emotional abuse
• History of behavioural issues and participation in a punitive behavioural program
• Emergence of suicidal ideation upon entering adulthood
• Balancing burnout symptoms, immediate safety concerns, and trauma history

Autistic Male, Age 44

• Recent diagnosis, realisation of how much he was masking
• Unpack history and process how much he was compensating
• Sudden decline in “functioning”

Limitations of Research and Risks of Interventions

Target Audience

• Psychologists
• Counsellors
• Social Workers
• Art Therapists
• Marriage and Family Therapists
• Speech-Language Pathologists
• Occupational Therapists
• Occupational Therapy Assistants
• Behavioral Intervention Specialists
• Psychiatrists
• Probation Officers
• Clergy
• Other helping professionals who work with autistic adults