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Family Counseling?

Bobby Newman, Ph.D., B.C.B.A.

OK, I have to admit it. I have never really liked the biblical story of the "prodigal son." There, I said it. I know what the meaning of the story is supposed to be, but I feel terrible for the son who stayed at home, working with his father all those years, doing everything he was supposed to, and never getting a party the way his wayward brother did when he came home, nor seemingly any acknowledgment at all.

Siblings of children with autistic-spectrum disorders are sometimes placed into a position much like that of the sibling of the prodigal son. Brother or sister does what (s)he is supposed to, behaving as appropriately as possible and listening (usually) to what mom and dad say, doing their school work and doing everything their family and society expect of them. And yet, sometimes they can't have their friends over because it's disrupting the sibling's ABA. Maybe the family can't go to Disneyland because of the difficulties in traveling or waiting on lines with the sibling. Maybe all the finances of the family have been drained trying to fight the disorder, and the sibling can't enjoy all the little extras in life that they see their friends who do not have disabled siblings enjoying. Do we possibly expect a level of emotional maturity and self-sacrifice that is beyond their years, and without even an acknowledgment?

How about mom and dad? Everyone on god's green earth has suggestions for what they're doing right and wrong. There's a never-ending series of newspaper clippings from well-meaning friends and family, suggestions for television programs to watch, and the ever-present threat of disapproving looks or comments from passers-by who don't understand why it is necessary to let a child tantrum at times, and why it is necessary that you change the route home periodically due to a child's obsessions.

We're thankfully away from the time when mom and dad (mostly mom) were blamed for the child's autistic-spectrum disorder. Mom and dad are no longer forced into therapy by misguided professionals. Yet, have we gone too far in the other direction? Have professionals forgotten the enormous strain that the siblings and families of a child with an autistic-spectrum diagnosis feel?

Parents are the hinge-pin of the ABA effort. Without the parents able to fully participate in making sure that ABA-based therapy is going well, keeping on top of programs and working for generalization and maintenance, all is lost. If parents and siblings don't "have their heads in the game," behavioral progress for the disabled sibling is sure to slow.

I often tell parents I'm working with that they must remember to take some "me time." Whether it be tennis lessons or a massage or some other activity to just "get away from it all" on a regular basis, parents must remember to take time for themselves to recharge their batteries and should facilitate activities for the siblings to do so as well.

Recently, a parent who called me, knowing that I do behavior therapy for anxiety states and sexual dysfunctions and other such issues. She asked if I would consider taking her on as a client, not to provide ABA for her son or to provide her with parent training, but rather just to act in the role of behavior therapist, or psychotherapist if you prefer. I asked if she wouldn't rather speak to someone who wasn't so tied in to the autistic-spectrum field. She told me that she wanted to see me for precisely that reason. Of all the therapists she considered, she didn't feel that any of them would really have an inkling as regards her life because they weren't intimately aware of the issues the parents and family face raising a child with autism. She had heard of me spending 18 hours in a bathroom at a shot to toilet train a child, and painstaking working through a 107 step task analysis to teach tooth-brushing. A therapist who hadn't been there and done that would be in no position to understand or counsel.

I took the parent on as a client. There was much we could do. She knew her child's condition was not her fault, but she still couldn't help slipping into irrational thought patterns on occasion. We worked on cognitive therapy exercises to address this. We worked on relaxation exercises to help her when she got too tightly wound. We worked on assertiveness training so that she would be able to stand up to the pressures of battling her CSE. We did some thought-stopping and deep breathing exercises to deal with panic attacks that she felt on occasion. Did we ever discuss the principles and procedures of ABA? Yes, we did, but only in terms of how what she was doing was effecting her son's behavior and her reactions to these behaviors. Therapy gave her the tools and coping strategies to keep up the fight and to help her son.

Professionals in the ABA field who have "another life" as behavior therapists or psychotherapists for other conditions would do well to remember the amazing array of tools they would be bringing to working with the parents or sibling of a child with an autistic-spectrum diagnosis. Many parents are hesitant to talk to professionals outside the autistic-spectrum field. Such professionals may not have kept up on the literature, and may hit parents with 40 year old misinformation. Beyond that, such professionals may just not "get it."

Parents who are faced with helping a child who is diagnosed with an autistic-spectrum diagnosis would do well to remember that they are only human. They have needs and only so much strength. Seeking some professional help is not an admission of defeat, but a marshaling of forces to make sure that one has the resources to carry on the fight. Remember, if you're not able to stay in the game, everything else is likely to fall apart.

Bobby Newman, Ph.D., C.B.A. is a licensed psychologist and certified behavior analyst.

Dr. Bobby Newman has offices in Manhattan, Long Beach, and, Long Island.

http://www.room2grow.org e-mail at darkoverlordaba@prodigy.net

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