Systemic psychotherapy with families where someone has an autism spectrum condition

Abstract

Background: Families play an important role in facilitating the development and well-being of children with autism spectrum conditions.

Objectives: After setting the scene with a clinical example, and providing a brief discussion of the current thinking about the aetiology of Autism spectrum conditions, this paper provides a review of the literature regarding the practice of systemic psychotherapy with families in which a child has an autism spectrum condition (ASC).

Methods: A search of databases and journals revealed a large number of opinion papers regarding how family therapists might work with families of children with ASCs and a smaller number of papers that describe or explore actual clinical practice.

Results: Pilot studies using qualitative methods and practice-based evidence in the form of descriptions of clinical work offer a solid footing on which to develop systemic practice to help families where a person has an ASC.

Conclusion: Given the multifactorial nature of the aetiology of ASCs it is suggested that systemic interventions have the potential to influence changes at multiple levels of functioning for the child and the family.

Keywords: Autism spectrum condition; family therapy; systemic psychotherapy.

Fig.1

The way in which the child’s brain ‘works’, (the brain itself being influenced by a variety of intrinsic and extrinsic factors), affects all aspects of the child’s functioning. Over time, both implicative and contextual forces create a bi-directional relationship between brain, child, and the environment of the family, the broader community and society. This biopsychosocial framework demonstates that each level of functioning needs to be understood, and can be influenced, by all other levels. After Bronfenbrenner (1979), Gutstein (2009), Crittenden et al. (2014) and Cronen (1994). Factors within the child lead to a relational dance that becomes increasingly mis-attuned. This mis-attunement then affects and is affected by the wider context and unusual patterns of interaction and behaviour becomes increasingly fixed. Contextual factors are those that impact from the broader context down towards the child. Implicative factors are those that ripple out from the child to the family and to the wider context.