Emotion-focused therapy for autism spectrum disorder: a case conceptualization model for trauma-related experiences

People with Autism Spectrum Disorder (ASD) report painful experiences through emotional misunderstandings with typically developing (TD) peers. There are limited intervention methodologies for ASD on the impact of emotional injuries and how to work with resulting trauma. This paper presents a rational-empirical model of trauma-related experiences with the first presentation of a new case conceptualization model for Emotion-Focused Therapy for ASD. It describes the transformation of problematic emotion schemes through a sequence of emotional processing steps illustrated with a case example. These steps include: overcoming differentiation of core painful feelings (such as loneliness, shame, and fear); autobiographical memory recall of distanced trauma, using a novel method of video Interpersonal Process Recall; and articulation of the unmet needs contained in core painful feelings. This is followed by the expression of an emotional response to those feelings/needs; typically, self-soothing, protective anger and compassion responses offered interpersonally by group members. These emerging adaptive emotions facilitate mentalization of self and other that strengthens intrapersonal and interpersonal agency. This rational-empirical case conceptualization acts as a hypothesis for testing in subsequent trials.