Looking after the Mental Health of Girls with Autism

A Guide to Mental Health Issues in Girls and Young Women on the Autism Spectrum: Diagnosis, Intervention and Family Support is the first book to look specifically at how mental health issues relate to girls and young women with autism, covering theory, research and tailored interventions for support.

In this extract, taken from Chapter 6 on Anxiety and Depression, author Dr Judy Eaton explores the results of a number of studies into anxious behaviour in girls and young women on the autistic spectrum. 

Evidence suggests that an estimated 40 per cent of individuals on the autism spectrum will suffer from high levels of anxiety (Van Steensel, Bögels and Perrin 2011). Clinical experience would suggest that this figure is likely to be higher, particularly amongst those with the pathological (or extreme) demand avoidance profile. In an earlier version of the DSM, DSM-III (APA 1980), ‘sudden excessive anxiety’ and ‘unexplained panic attacks’ were included amongst the core criteria for a diagnosis of autism. However, subsequent versions of the DSM (IV and V) do not include this. The reason for this is not entirely clear. Hallett et al. (2013) cite the meta-analysis by White et al. (2009) which found that between 11 per cent and 84 per cent of children with a diagnosis of autism display anxiety. Of the 31 studies analysed 30 per cent were diagnosed with specific phobias, 17 per cent had obsessive compulsive disorder, 17 per cent had social anxiety and 15 per cent reported features of ‘generalised’ anxiety. Their results suggested that children with autism were twice as likely to develop anxiety disorders compared with their neuro-typical peers. High levels of anxiety have a negative impact upon education, social relationships and social participation and on other members of the immediate family group (Reaven 2011). There is also an increased likelihood that these anxiety disorders will persist into adulthood.

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A worksheet to help young people manage the stress of exams

Age range:

Ages 10+

Description:

A self-help CBT worksheet that provides a host of tips, strategies and behaviour techniques to help young people manage the stress of exams.  It includes an exam stress diary with relaxation exercises to help monitor your emotions, and explains the importance of getting into a good routine, not wearing yourself out but also not procrastinating too much either.

Click here to download the resource

This extract is taken from Kate Collins-Donnelly’s Starving the Exam Stress Gremlin, and is the latest instalment in her bestselling and award-winning Starving the Gremlin series. Full of fun activities based on cognitive behavioural therapy, the Gremlin series teaches young people to manage common emotional and behavioural difficulties such as anger, depression and anxiety.

Self-help exercises to help older children manage worry and anxiety

managing anxietyAge range:

Ages 9+

Description:

An engaging, self-help guide based on cognitive behavioural therapy that teaches young people mindfulness techniques to alleviate their worry and anxiety.  Strategies include ways to shift your attention away from your worry, not to fall into a debate with it, and learning to accept rather than fight your anxiety when it is present.

Click here to download the resource

This extract is taken from bestselling author Dawn Huebner’s new book, Outsmarting Worry: An Older Kid’s Guide to Managing Anxiety.  Written in language immediately accessible to children, it teaches young people, and the adults who care about them, specific skills that make it easier to face and overcome their worries and fears. 

JKP Author Honored as Book Award Finalist

JKP Author Dr. Lee A. Wilkinson was recently honored as an Award-Winning Finalist in the “Psychology/Mental Health” category of the 13th Annual Best Book Awards for his book, Overcoming Anxiety on the Autism Spectrum: A Self-Help Guide Using CBT. Selected from more than 2,000 entries from traditional and independent publishers, 400 winners and finalists were announced in over 100 categories. This is the second award for Dr. Wilkinson whose JKP book, A Best Practice Guide to Assessment and Intervention for Autism and Asperger Syndrome in Schools was selected as the winner in the Educational/Academic category of the Next Generation Indie Book awards.

About Overcoming Anxiety and Depression on the Autism Spectrum

Dr. Lee A. Wilkinson’s award-winning book presents strategies derived from cognitive-behavioral therapy (CBT), adapted specifically for adults on the higher end of the autism spectrum, to help them overcome anxiety and depression, and improve their psychological well-being. The author takes the best of CBT therapeutic techniques to facilitate greater self-understanding, self-advocacy, and better decision-making in life-span activities such as employment and interpersonal relationships.

Accessible and easy-to-read, this self-help guide provides evidence-based tools that can be used to learn new self-fulfilling ways of thinking, feeling, and doing. It includes questionnaires, forms, worksheets, and exercises to help the reader:

  • Evaluate his or her autistic traits and discover their cognitive style.
  • Identify and modify the thoughts and beliefs that underlie and maintain the cycles of anxiety, depression, and anger.
  • Apply therapeutic techniques such as mindfulness, positive self-talk, guided imagery, and problem-solving.
  • Accept the past and achieve unconditional self-acceptance.
  • Deal effectively with perfectionism and low frustration tolerance.
  • Avoid procrastination and learn to maintain the positive changes to their progress.

Used alone or in combination with therapy, Overcoming Anxiety and Depression on the Autism Spectrum: A Self-Help Guide Using CBT is an essential self-help book for adults on the higher end of the spectrum looking for ways to understand and cope with their emotional challenges and improve their psychological well-being. It is also appropriate for adults who recognize their autistic traits, even though they may not have experienced major social difficulties and clinical impairment, but who want to improve their emotional well-being. Family members, friends, and others touched by autism will find this self-help book a valuable resource as well.

About the Author

Lee A. Wilkinson, PhD, is a scientist, researcher, and practitioner. He is a licensed and nationally certified school psychologist, chartered educational psychologist, registered psychologist, and certified cognitive-behavioral therapist. He is also a university educator and trainer, and has published widely on the topic of autism spectrum disorders both in the US and internationally. Dr. Wilkinson is author of the award-winning book, A Best Practice Guide to Assessment and Intervention for Autism and Asperger Syndrome in Schools, also published by Jessica Kingsley Publishers and editor of a best-selling text in the American Psychological Association (APA) School Psychology Book Series, Autism Spectrum Disorder in Children and Adolescents: Evidence-Based Assessment and Intervention in Schools. His latest book from JKP is A Best Practice Guide to Assessment and Intervention for Autism Spectrum Disorder in Schools (2nd Edition).

Borderline Personality Disorder: One Step at a Time

Tracy Barker, author of A Sad and Sorry State of Disorder, is an expert by experience on how to live with and manage borderline personality disorder (BPD), now a happily married home maker committed to raising awareness of BPD, she has written an emotional and honest piece on how it feels to have BPD, the struggles and how to deal with it; one step at a time.

One step, then take a break –
a few days, to recover.
One step, then rest
before embarking on another.

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The University Years: Claire Eastham discusses living with social anxiety

University

University can be a difficult time for anyone, but throwing social anxiety into the mix just makes it that much harder. Claire Eastham, author of We’re All Mad Here, has battled with her social anxiety for many years, from her school days, through university and even when she started working in her dream job in publishing. In this extract, she discusses how going to university affected her mental health and the different ways she tried to combat her anxiety. She also touches on the exam stress, social media and the pressure of fitting in.

Click here to read the extract

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Creative coping strategies to help young people manage stress, anxiety and other big feelings

Age range:

Ages 8 – 14

Description:

A colouring book and journal filled with uplifting quotes and poems that encourages children experiencing stress, anxiety and other big feelings to manage their emotions. With a range of activities that introduce mindfulness and encourage relaxation, the workbook is designed to prepare young people for future difficult situations.

Click here to download the resource

This extract is taken from Pooky Knightsmith’s The Health Coping Colouring Book and Journal, which is designed to help young people manage difficult thoughts, feelings and emotions such as anger and anxiety.

How to help children manage anxiety and embrace their imperfections

Rochel Lieberman, author of Pearla and her Unpredictably Perfect Day, an empowering story that teaches children how to embrace their mistakes and practice resilience, discusses how parents and professionals can use her book to help children who struggle with anxiety and perfectionism.

When I crafted the characters and the story line of Pearla and Her Unpredictably Perfect Day, I visualized creating a tool that can be easily used both at home and at school. My goal as an author was influenced by my perspective as an Executive Speech Coach, where I spend most of my time working with and on behalf of children. In that capacity, I have educated children, their teachers, therapists, principals, and leaders. Above all else, I’ve gone through this journey as a mom, working alongside educators, helping them bring out the best in their own pupils. Thus, I wrote this book with the following vision: for parents, a book that is simple and can be used flexibly in the fine balancing act that is required of parenthood; for schools, a guide for conversations between children and their teachers or therapists.

I have always viewed books as magical instruments, with the power to transcend reality while simultaneously reinforcing our daily experiences. About fifteen years ago, as a college student, I vividly recall riding a New York City bus alongside a mom and her adorable little boy. Like a real New Yorker, she had a great designer bag—yet with an odd rectangular object poking out of the side. My curiosity was short lived, as her son quickly became bored of looking out the window, prompting her to empty some of the treasures from her bag. Amidst the emerging apple sauce and fruit snacks, the large rectangular shape materialized as a children’s book, which allowed her to entertain and delight her son for the remainder of the bus ride. This mom recognized that alongside a cellphone, keys, and snacks, there was a treasure in carrying a children’s book.

Any adult who has ventured into the land of storytelling with a child knows how widespread the benefits can be. Stories let readers connect with characters, like Pearla, who are having similar challenges, but in a nonthreatening way. They open the door to on-the-spot questions and sometimes even deeper conversations about the way life works, even when it’s not working out well. My hope for parents is that by reading this book together with the child in your life, you can reflect on the story and learn to recognize the triggers that caused Pearla distress, such as Pearla’s desire for perfection, and also learn from her healthy ability to strategize in times of stress. Then, you can have a purposeful conversation to relate these ideas, as applicable, to your own child’s obstacles.

For example, if your child struggles with anxiety from a need to perform perfect work, you can engage in a conversation about making mistakes in general and the thoughts and feelings associated with doing so. With Pearla’s fun storyline, my goal is that you can explore these normally sensitive topics in a casual mode, rather than in a “teaching” mode. To facilitate these conversations, I have included suggested questions in the back of the book. Some examples include questions for recognizing perfectionist tendencies (What do you like to have “perfect”?) and questions that allow the child to reframe their thinking about a perceived negative event (When does Pearla start to see that her cookies and cupcakes are perfect just the way they are?)  Keep in mind that these questions can be used as guides to formulate your own question, so that you can speak in a manner that is true to your own communicative style.

As parents, you can use your life experiences or situations other family members have encountered as examples, so your child is reminded that we all make mistakes. You can carry this one step further and talk about the idea that we all expect to make mistakes most every day, and we all have to deal with imperfect situations every day. If you expect to be going to a challenging place, with expected tension or changes of schedule, you can better prepare your child by using words to roleplay the situation and discuss which choices or behaviors are best suited to dealing with the expected encounter. In my experience, these conversations are best done either before or after an event, when the child is not in direct placement of the stressor. Remember, repairs are done after the rainstorm. In the middle of a challenging event, whisper words of encouragement and praise to your child. The longer talks, references to Pearla, and conversational questions can be saved for dry, sunny days.

The character of Pearla arose from my many joyful and zany experiences as a writer, as a mom raising my children, and from my years as a speech language therapist providing services to a wide range of children and adults. Through it all, I observed the growth and powerful learning that clients achieved when they courageously challenged their core beliefs on failure, perfection, and fear of daily challenges. All of us, children, adults, and caregivers alike, are on a journey with many bumps on the surprising road of life. While some of us learn to ride the bumps and face the challenges, others, like Pearla, find it very difficult to handle these imperfections without the help of a caring adult or professional.

A caring therapist, teacher, or allied professional can help children learn to accept impossible-to-avoid changes and challenges in their daily life. Remediating these negative and unhealthy beliefs and feelings is so important, because many times children and adults can carry these painful feelings, along with the ever elusive search for perfection and order, throughout their life’s journey. It is my dream that this book can be used as a tool to foster better social skills by sparking discussions in the classroom or in the safety of a therapist’s office at school or in private practice. The therapist can begin the sessions by attempting to understand the core of the child’s feelings about challenges and beliefs about making mistakes.

Research supports the calming effects of labeling an emotion, as is done in this story (look for the colored phrases in the text). In the privacy of a therapist office, where a child can relate their own story, the therapist can help them label their emotions, using the book as a model. The child and therapist can talk about everyday situations where they may be triggered to experience those emotions. Then, to advance the conversation, the therapist can use the time to problem solve with the child and generate solutions for these everyday experiences.  They can discuss possible scenarios or alternative plans that Pearla may have done that would not have been beneficial, such as screaming, stomping her feet or having a tantrum in front of the customers. This can lead to practical discussions about the consequences for each of the solutions that the child suggested.

In a more structured format, the therapist can probe the child with the following questions from the book’s suggested questions in order to help the child recognize emotions (What part of your body begins to hurt when you feel afraid?), to bring awareness to the words that the child says to himself (What words do you think when you feel afraid?) or to gently elicit support for the child (What thoughts can you think to help you feel less afraid?). These conversations are essential, as research supports that the specific words that you say to yourself  can alter the way you behave. Answers to these questions will slowly open the door to dealing with daily challenges and imperfections. As one client once said to me, “I am good even though I am not perfect.” There is a lot to be learned from the wisdom in those words. Enjoy reading Pearla and Her Unpredictably Perfect Day with the child in your life and let the talking and learning begin.

 

You can learn more, read reviews, or purchase a copy of Pearla and her Unpredictably Perfect Day here. To learn more about the author, visit Rochel Lieberman at www.ariberspeech.com, or connect with her on Facebook or Twitter.

The extraordinary projects making mental health a key player in the school day

mental health schoolsJenny Hulme, author of The School of Wellbeing, discusses her new book and the projects she’s explored that support students’ emotional wellbeing. At a time when the state of young people’s mental health is being recognised as central to their learning and attainment, her book gives unique insight into these projects and features the education leaders and charities behind them, including Place2Be, Kidscape, Beat and more.

When I started writing this book a year ago, the media were talking, ever more urgently, about the epidemic of young people at odds with the world around them. Research was suggesting rates of depression were rising in primary schools and anxiety among teenagers had increased by 70 per cent in the past 25 years. Meanwhile, reports noted the rapid rise in hospital admissions for young people with eating disorders. Every story posed more questions than answers about the role of everything from poverty to education policy, exam stress to social media. Other more recent headlines included news of a 14 per cent rise in teenagers being admitted to hospital after self-harming, with the NSPCC saying they delivered thousands of counselling sessions on self-harm last year (as many as 50 a day) via Childline. It was heartening to read at the same time talk of the Government making relationships and sexual health a statutory subject to tackle the problem of sexual harassment and sexting in schools. But developments like this come not a moment too soon. Continue reading

Coping with anxiety at Christmas if you are on the autism spectrum

The author of bridge-bridge_autism-anxiety_978-1-78592-077-6_colourjpg-printAutism, Anxiety and Me: A Diary in Even Numbers, Emma Louise Bridge, offers advice for those with autism on how best to cope with anxiety at Christmas time.

 

The shopping, the crowds, the parties, and the art of present giving… it is easy not to feel quite so wonderful at this most wonderful time of year. However as much as Christmas is one of those times of year that is just unavoidably stressful, it doesn’t mean you can’t plan ways to survive the holidays. At best you can have lots of fun, and at worst, well you can at least make it through.

The first step in holiday survival is planning. I personally like to do this with lists; even-numbered of course. Even if you’re not hosting the in-laws or planning a party, you will be surprised how much at Christmas can be thought out beforehand to save zig-zags in blood pressure. To provide a more in-depth example let’s take present-giving; something that I find far more stressful at Christmas than any other time because it is reciprocal. So, first plan out the details.

  • Who do you have to buy for?
  • Who will probably be buying for you?
  • What is your budget?
  • What you are going to buy?

Now I love surprises but at the same time I don’t, mostly because the need to make sure that all my gifts are either of an equal monetary or emotional value as those given to me is too great. The easiest way to ease this stress is to introduce wish lists. Ask everyone what they want. If you want to choose something then ask them for a list of different options. On the same principle you can produce a list yourself. Even if no-one asks, produce a list of things you really want and just offer it as a suggestion. Even if other people weren’t expecting it hopefully they will respect it as a way to make Christmas a little easier – after all everyone should be able to have fun.

Other lists can include:

  • Anything you need like decorations or advent calendar
  • Any parties you are invited to / hosting
  • Who is coming or where you’re going over the holidays
  • Any events such as carols or services that are going on
  • Food you need to buy


Planning, planning and more planning!!!

The second step to surviving the holidays is the guide to surviving parties. Christmas parties generally involve a lot of food, a bunch of being social and loud super cheerful music. So first things first: know you’re going to eat more over Christmas. It just seems to be inevitable, so plan ahead for that. Also if you know you’re going to go to a party where you might not be able to eat anything – because your entire family are on special diets – but you’re going to be super hungry because there is food everywhere… putting something in your handbag or pocket for emergencies is a seasonal must.

The other thing that stresses me out at parties is the number of people who are going to ask how life is going, what my plans for the New Year are, how my job is, how much I have grown etc. Now the answer to some of those questions never changes – ‘nope, still the same height’ / ‘yes it has been years’ / ‘happy Christmas to you too’ – but there are some conversations where stock phrases won’t do. This can be tough especially if your life isn’t necessarily where you want it to be or you don’t have much to talk about. The answer is simple and something I have learned over the years of trying to master the art of surviving in society. People love to talk about themselves, so bring the conversation back around to them every time you feel uncomfortable and you’re on to a winner. Even better, join a group where there are a couple of people who love to talk and happily be a background listener for as long as you can get away with it.

Also keep in mind that you’re bound to not be the only person in the room who isn’t exactly where they want to be at that point. Doesn’t mean you won’t ever be.

So my final surviving the holidays tip is this – don’t be worried about asking for help. It’s okay to not feel brilliant even if the world is covered in Christmas cheer. It is okay if it is hard or emotional. There could be a hundred reasons why. I know it is really easy to feel you have to shove a smile on your face and fake it ‘til you make it. And sometimes trying to tough it out is the right decision. But sometimes you just have to sit down and admit to yourself, or to someone you trust, that you could use some help. Or even just that you could do with being cut some slack. Don’t compare yourself to anyone else… you survive the holidays the best way you know how.

In conclusion:

  • Lists are awesome
  • Parties are survivable – just go in prepared
  • Survive Christmas the best way you know how – don’t let anyone tell you how you have to be

 

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