In supervision, our main attention lies in establishing trusting relationships with young autistic children by applying a range of reciprocal play and interaction techniques in a dyadic setting that is informed by an underlying framework of systemic-analytic thinking.
The question: "How to connect and find a path towards more reciprocity in the interaction?" seems to be a fundamental and recurring theme, that occupies most therapists' minds at some stage during their work with children on the spectrum, no matter how experienced they are...
Precisely this initial negotiation between "me - you - we" in the sessions tends to be the trickiest challenge in building a secure and reliable treatment alliance with an autistic child.
Instead of playing in a mutually agreeable and interactive manner, a child, at first, may refuse to participate in the session and may demand that certain objects are used solely in highly ritualised and stereotypical patterns, that often excludes the other person in the room.
If the therapist dares to "disobey the rules" by manifesting as a separate self with their own intentions or ideas in the session, a child's reaction can turn out to be very challenging .
Often then deep-seated insecurities, anxieties, frustration or confusion are triggered in the dyad, and the encounter leads to a kind of "crossroads scenario":
On the one hand one might be tempted rather to circumnavigate the difficult emotions to avoid further trouble and upset; On the other hand, however, one might decide to meet the situation head on and attempt to deal with the arising emotions (and any possible fallout), in a constructive and co-regulative manner.
Developmentally speaking, I regard any such crisis, as a most important opening and opportunity that should not be missed once it comes to pass in a therapy session. Crises can convert into essential developmental stepping stones, but they can only be negotiated and resolved within a trusting relationship, where the child feels safe and held.
Conscious co-regulation in the dyad paves the way to an improved capacity of affect-regulation and a more defined sense of self and others. Facing and "surviving" difficult emotions together deepens trust and results in a more reciprocal and stable therapeutic relationship.
This, in turn, often enables the child to engage more cooperatively and productively with the initial aims and objectives of the specific therapy method applied. It is a beneficial investment!
However, focussing on joint affect-regulation in the difficult moments of a child's intrapsychic crisis can be both complex and challenging. Safe and professional clinical practice, first and foremost, depends upon feeling safe and contained oneself.
Through our shared supervision we seek to create a containing and reflective space that allows us to think together, to gain insight, to digest difficult experiences, to jointly attribute meaning, and to reach new perspectives on the processes at hand. Together we will then discover the most appropriate interventions and autism-specific interaction techniques to meet the particular challenges of your case load.
I look forward to offering you my extensive clinical experience and expertise in early intervention and accompanying you as a supervisor for part of your professional and personal journey.
