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Chris Blankenship, LCSW | Clinical Therapist | Transition Age Young Adults

March 21st, 2019

How Wilderness Therapy Can Help Young Adult Women with Autism Spectrum Disorder 

Chris Blankenship, LCSW | Clinical Therapist | Transition Age Young Adults

Go to college…

Get a full-time job…

Form mature relationships and friendships…

Develop healthy interests and hobbies…

These are all benchmarks that 18-20 year-old females on the autism spectrum hope to accomplish. However, all too often these young women struggle to maintain their daily obligations, find difficulty socializing at an age-appropriate level, and participate in narrow, isolating interests.1,2,3 Females who have autism spectrum disorder (ASD), or who are displaying symptoms in line with ASD, can benefit from the assessment, support, learning, and family work that happens in wilderness therapy. In my work with transition-age young adults, I utilize a wide-ranging approach to assess, treat, and plan for the well-being of each student and family.

 

ASSESSMENT

The first step to managing a neuro-atypical disorder like autism is obtaining an accurate diagnosis. Generally, females are diagnosed with ASD less frequently than their male counterparts because they tend not to display some of the restricted or repetitive behaviors that males do,4 and they often present differently than their male peers in the wilderness. ASD symptoms in young adult females often include a delay in maturation, attentional or executive functioning issues, and anxiety and mood disorders, for instance.

Wilderness therapy is an effective environment for assessment because students receive around-the-clock monitoring from trained staff, are removed from their typical maladaptive coping mechanisms, and are immersed in a peer group which allows us to evaluate social skills. As a wilderness therapist, I use this environment to implement interventions designed to assess a student’s presenting symptoms, coping skills, and resilience levels. At Open Sky, students are also able to partake in comprehensive psychological testing when necessary—an essential process for an accurate ASD diagnosis. In these ways, wilderness therapy helps students—and their families—to truly understand what has kept them from taking advantage of their new-found adulthood.

 

TREATMENT

Physiological Wellness

Research shows that adults with ASD have significantly higher rates of physical health issues.6 Healthy skills and habits pertaining to self-care and physical health often go by the wayside when young adults on the autism spectrum try to differentiate from their parents. Getting plenty of restful sleep can be a challenge for adults with ASD.7 Adult females on the autism spectrum are also significantly more likely to have selective eating patterns, gastrointestinal issues, and disordered eating.8

Wilderness therapy helps students understand the importance of physical health. At Open Sky, students are able to lean on the round-the-clock guidance from field staff as they develop routines for self-care. Students practice good habits with nutrition, sleep, exercise, and care for their bodies.

The concept of “food as medicine” is foundational to Open Sky’s holistic programming. Students are taught the importance and value of a balanced and nutritional diet. With food as a foundation of treatment, I can help young women with ASD understand the intersections of physical and mental health. Success in wilderness therapy also requires plenty of restful sleep. While at Open Sky, students have at least 8 hours to sleep each night and they are taught tools to fall and stay asleep.

By putting such a premium on physical health, students with ASD are able to confront some of the more debilitating components of their presenting symptoms and diagnoses. The skills and healthy physical habits our students learn can be translated to life beyond wilderness.

 

Social Wellness

What is clear from both research and my personal observations is that females with ASD are often striving for close social connection. The wilderness therapy model provides a built-in peer group with inherent opportunity for constant reflection and learning. This is a perfect training ground for tackling one of the biggest deficits women on the spectrum face. Students learn verbal and non-verbal communication skills necessary for connecting with others and building relationships.

However, since females with ASD are already prone to imitating social acts and trying desperately to follow strict social scripts,10 I strive to help clients understand the bigger picture of relationships. I guide them in understanding how relationships, and their role in them, evolve over time. Immersion in a group of peers and field guides allows for ongoing social understanding and skill building that is hard to replicate in other treatment settings.

 

Mental Health Wellness

In addition to providing a supportive environment for improving physical and social skills, Open Sky offers treatment for the mental health issues often associated with ASD. Young adults who are on the autism spectrum experience significantly higher rates of mental health issues than their peers. These symptoms can be based in mood, anxiety, and executive functioning disorders, to name a few.

I utilize a combination of cognitive behavioral and mindfulness-based treatments that prove effective for treating mental health issues in adults who are also on the autism spectrum.12,13 These techniques allow students to learn how to better regulate their emotions and reactivity. They help students begin to challenge maladaptive thinking and behavioral patterns. When combined with social skills training and physical wellness, these mental health skills contribute to the holistic treatment that is foundational to Open Sky’s model and the success of our students.

 

FAMILY SUPPORT

The participation of the entire family system is critical to the success of any Open Sky student. By participating in opportunities such as Wellness Weekend and Family Quest, parents learn the same relational and communication skills that their child is learning in the wilderness. This is particularly helpful for parents trying to understand and relate to their child with ASD.

The training parents receive through Open Sky’s Family Services and their weekly phone calls with me as the primary therapist is invaluable to overall family health and the student’s long-term growth. It helps parents replicate the support their child receives in the field. It prepares them to understand, encourage, and support their child in the transition after graduating from Open Sky. Family involvement and support back home is an integral step toward long-term growth for both the individual and the entire family system.

 

TRANSITION TO ADULTHOOD

The structure and support of a wilderness therapy program means nothing if the skills learned cannot be translated to life beyond wilderness. A survey of young adults on the autism spectrum found that they are most in need of assistance building adaptive skills that are relevant for their everyday life.14

My goal is for the skills my clients learn and practice in our sessions and daily life in the field to become engrained in their minds and behaviors. To that end, I work with students and families to understand how their Open Sky skills can be used outside of the woods and the desert. We build a comprehensive plan for long-term treatment and success after Open Sky. Our Transition Mentors provide the guidance and support throughout the graduation and transition process. They connect with students and families following graduation, and help them re-connect and implement the skills they learned.

Transitioning into adulthood can be a unique and beautiful, yet challenging process for almost everyone, let alone for those on the autism spectrum. The physical, social, and mental health issues that accompany ASD enhance the challenges of this time of life. Nothing gives me more joy than seeing my students thrive at Open Sky and go on to maintain healthy routines, attend school, get a job, and engage in mature relationships and activities.

 

IN HER OWN WORDS…

Meghan, Alumni Student, 2019

“Open Sky honestly changed my life. When I first arrived, I had lost most of my self-confidence. I did not believe that I could do anything… Then I was diagnosed with Autism Spectrum Disorder and I felt like I had found a missing part of myself, but I still struggled to grasp it.

Being diagnosed at Open Sky was really one of the best things that could happen to me… Chris helped me discover who I am and taught me how to be the best version of me. He related everything he taught me to my field of study: education. He showed me how each skill can be used in an elementary classroom and had me practice each skill.

Open Sky did not change who I am but taught me who I truly am and who I can be. I left a confident young adult who felt like she could conquer the world and overcome anything. I am now back at college. Next semester, I am going to student teach and get my teaching degree. The following year I plan to get my master’s in special education and help teach students like me. Open Sky prepared me for life and I’m living mine to the fullest.”

Read Meghan’s full testimonial HERE.

Resources 

  1. Taylor, J. L., & Mailick, M. R. (2014). A longitudinal examination of 10-year change in vocational and educational activities for adults with autism spectrum disorders. Developmental psychology, 50(3), 699. 
  2. Frazier, T. W., Georgiades, S., Bishop, S. L., & Hardan, A. Y. (2014). Behavioral and cognitive characteristics of females and males with autism in the Simons Simplex Collection. Journal of the American Academy of Child & Adolescent Psychiatry, 53(3), 329-340. 
  3. Lai, M. C., Lombardo, M. V., Auyeung, B., Chakrabarti, B., & Baron-Cohen, S. (2015). Sex/gender differences and autism: setting the scene for future research. Journal of the American Academy of Child & Adolescent Psychiatry, 54(1), 11-24. 
  4. Halladay, A. K., Bishop, S., Constantino, J. N., Daniels, A. M., Koenig, K., Palmer, K., … & Taylor, J. L. (2015). Sex and gender differences in autism spectrum disorder: summarizing evidence gaps and identifying emerging areas of priority. Molecular autism, 6(1), 36. 
  5. Murphy, C. M., Wilson, C. E., Robertson, D. M., Ecker, C., Daly, E. M., Hammond, N., … & McAlonan, G. M. (2016). Autism spectrum disorder in adults: diagnosis, management, and health services development. Neuropsychiatric disease and treatment, 12, 1669. 
  6. Croen, L. A., Zerbo, O., Qian, Y., Massolo, M. L., Rich, S., Sidney, S., & Kripke, C. (2015). The health status of adults on the autism spectrum. Autism, 19(7), 814-823. 
  7. Richdale, A. L., & Schreck, K. A. (2009). Sleep problems in autism spectrum disorders: prevalence, nature, & possible biopsychosocial aetiologies. Sleep medicine reviews, 13(6), 403-411. 
  8. Berry, R. C., Novak, P., Withrow, N., Schmidt, B., Rarback, S., Feucht, S., … & Sharp, W. G. (2015). Nutrition management of gastrointestinal symptoms in children with autism spectrum disorder: guideline from an expert panel. Journal of the Academy of Nutrition and Dietetics, 115(12), 1919-1927. 
  9. Frazier, T. W., Georgiades, S., Bishop, S. L., & Hardan, A. Y. (2014). Behavioral and cognitive characteristics of females and males with autism in the Simons Simplex Collection. Journal of the American Academy of Child & Adolescent Psychiatry, 53(3), 329-340.  
  10. Attwood, T. (2006). The complete guide to Asperger’s syndrome. Jessica Kingsley Publishers. 
  11. Hill, E. L. (2004). Executive dysfunction in autism. Trends in cognitive sciences, 8(1), 26-32. 
  12. Spek, A. A., Van Ham, N. C., & Nyklíček, I. (2013). Mindfulness-based therapy in adults with an autism spectrum disorder: a randomized controlled trial. Research in developmental disabilities, 34(1), 246-253.
  13. Spain, D., Sin, J., Chalder, T., Murphy, D., & Happe, F. (2015). Cognitive behaviour therapy for adults with autism spectrum disorders and psychiatric co-morbidity: A review. Research in Autism Spectrum Disorders, 9, 151-162.  
  14. Pellicano, E., Dinsmore, A., & Charman, T. (2014). What should autism research focus upon? Community views and priorities from the United Kingdom. Autism, 18(7), 756-770. 
Chris Blankenship, LCSW | Clinical Therapist | Transition Age Young Adults

March 21st, 2019

Chris Blankenship, LCSW | Clinical Therapist | Transition Age Young Adults