I was recently asked to characterize the usual psychotherapeutic approach with those who are diagnosed within an autistic spectrum disorder. The questioner asked me to contrast Cognitive Behavioral Therapy (CBT) with psychodynamic psychotherapy. CBT has become, over the last two decades, a choice approach in the treatment of many disorders including depression and obsessive-compulsive disorder. It is sometimes effective as the sole treatment, or at other times, with medication.

CBT deals with the cognitions (more-or-less ideas, attitudes and preconceived notions) that one has developed throughout life that predisposes one to perceive and expe­ri­ence events and emotions in a certain way. It is based on the idea that we have learned ways of reacting, and that the maladaptive and distorted ways we react can be unlearned. For example, if one is exposed to teasing and bullying in childhood, he or she may have trouble anticipating positive expe­ri­ences with people later in life. This may then interfere with seeing people in a new light and thus in developing new relationships. CBT is generally brief and time limited. The behavioral part of CBT involves encouragement of the individual to engage in social and adaptive activities.
Psychodynamic psychotherapy is based on the idea that one’s present problems and conflicts are based in ones past and that an in-depth exploration of ones past is necessary to explain and resolve current problems. This in depth exploration is not time limited. Play therapy with children is more a psychodynamic approach whereas helping children to learn how to play in a social skills group is more in line with CBT.

In general, it appears that CBT is the more appropriate approach in the treatment of those diagnosed with an autistic spectrum disorder.