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Cognitive Behavioral Therapy (CBT): A Crucial Development in Treating Asperger’s

By Samar A.


Introduction

Violent cases of Asperger’s Syndrome have been depicted in the media more often in the last couple of decades. For instants, one of these cases is Adam Lanza, the 20 year old with Asperger’s syndrome who is famous for The NewTown Shooting that happened in Connecticut. Adam “left behind his mom, twenty children, and six adults all dead” (Sexton). This is one of the sudden shifts Asperger’s patients can have, which can never be predictable. Thus, they need much care and more serious action such as providing them with the treatment they need, which can possibly be Cognitive Behavioral Therapy. Asperger’s is a newly discovered disorder for the last decade since it is considered to be one of the most recent recognized psychological disorders in Psychology. Therefore, the treatments of this disorder are still in progress. A man named Hans Aspergers first discovered Asperger’s in the 1940s as a children behavioral syndrome. There are a lot of medical treatments for the disorder, but the most effective treatment for Asperger’s-afflicted children is Cognitive Behavioral Therapy (CBT). CBT is the most effective treatment because it has better results, last longer periods of time, and is more affordable than any other treatment.

What is Asperger's

Asperger’s is labeled now as an Autism Spectrum Disorder (ASD), along with other developmental disorders. Asperger’s is under the ASD category of disorders since it has some similar characteristics that it shares with other ASD. Furthermore, Asperger’s is defined as “ a severe developmental disorder characterized by major difficulties in social interaction, and restricted and usual patterns of interest and behavior” (“MAAP”). In addition Asperger’s patients share a lot of similarities with autism in terms of social behavioral responses, failing to make appropriate emotional responses, and having difficulties in reading body language. Children with ACD usually exhibit a lot of uncommon social interaction behaviors. Asperger’s syndrome patients don’t show any deficit in language production, or even in learning. In fact, in many cases, Asperger’s patient show high levels of intelligence. Their main deficit is failing to know how to interact with others around them in terms of emotional and behavioral responses. This disorder is mostly common among children, and it is also common in young adults. It is also a genetic disorder because it linked to genetic factors. A study by Harvard Mental Health Letter indicated why Autism as well as Asperger’s run on families and the chance of children having it with a parent with Autism or Asperger’s is from 65% up to 90%. There is at least seven genes associated with ASDs “When these genes are activated too soon, too late, insufficiently or excessively, they can interfere with the growth of the brain and the functioning of neurons” (“Harvard Mental Health Letter” 1-4).

Cognition and Perception

The behavioral responses and many other interpretations that we build up from our sensory organs are what neurons in an Asperger’s syndrome patient fail to connect together. Accordingly, cognition and perception is what Asperger’s patients tend to show deficit developing. Cognition is what we receive form the outside world using our sensory organs. Perception is how we interpret or acknowledge cognitive incoming information. Thus, Asperger’s is a neurobiological disorder, which is a result of a deficit in the brain system. The neural responses in specific parts of the brain are responsible for coding the information and reacting to events accordingly is where Asperger’s patients show deficit in. Moreover, Asperger’s patients fail to connect or link the cognition of what is around them and use the most suitable perception of how to interact with the event. For example, one of the deficits they have is learning how to show the appropriate emotional response in a death situation, so they might laugh or not respond to it.

Why CBT?

CBT was first discovered in 2005 and considered to be effective for children as well as for adults (Cognitive Behavior Therapy News). CBT is very unique and very different kind of therapy in comparison to other types of psychological therapy treatments. One of the reasons CBT is different is because there is more active interaction and involvement between the patient or patients (depending in what type of CBT it is) and the therapist. Similarly, CBT can be very specific in reaching a certain goal, which is defined in psychology as Problem- Focused, or Goal- Directed. Also, CBT treats more challenging symptoms, so they try to help patients who have been highly affect by the disorder. Another element of CBT is that it gives patients a lot of practice in how to cope with the disorder, and emphasis more on exposure therapy’s procedures. For example, a cognitive behavioral therapist would focus in only how to read facial responses of a happy person, and show patients pictures of people smiling, or maybe then take them outside and tell them to differentiate between facial expressions (Duckworth, and Freedman). CBT is a long-term effective therapy treatment for Asperger’s, in contrast to other medical and therapy treatments, which are being used for other disorders. In fact, it has shown a lot of improvements especially in children and patients who are at very high stages of the mental illness. CBT therapy is one of the most developed therapy treatment for Asperger’s. Furthermore, CBT has been used for other developmental behavioral disorders such as Obsessive Compulsive Disorder (OCD), Anxiety, and other type of ASDs. Overall, CBT is a type of therapy that aims to examine a patient’s patterns of connections between feelings, thoughts, and behaviors.

CBT for Children

CBT has been used with both children and adults; in fact, it is one of the best therapy treatment for both children as well as adults have shown equal amount of coping when use for the same amount of time. Children with ASD or Asperger’s show very significant improvement over time. To illustrate, one of the case studies titled The Treatment of Social Phobia in a Young Boy With Asperger's Disorder measure the time of coping and the progress based on age was a child nicknamed in the study as “James,” a six year old with Asperger's disorder and social phobia. James was first diagnosed with Asperger’s at the age of three. He has shown a lot of improvement during these last three years. He has had 11 sessions of CBT in a period of three months. In his therapies, he also had to do some outside homework like most CBTs, where he would be asked to interact with others with the help of his parents. For instance, he would be asked to interact with his cousins in big family gatherings, and his parents would provide detailed information about his behavioral responses. Up until this point James has shown fearfulness, avoidance, quietness, and more importantly his visibly anxiety of others, even the therapist as well as the investigator. The results “James” showed were very positive. First, he has shown a significant reduction in negative avoidance behavior. Moreover, he showed more relaxing demands when interacting with the therapist that will increase, as the sessions progress. All data proves how CBT helps improve behavioral symptoms of children with ASDs (Schleismann, Gillis).

CBT for Adults

Adults take much longer time to show such an improvement with treatments generally. Adults tend to take longer time for two main reasons. The first one is because they usually tend to be at a higher-functioning stage, which suggests why they need more time to get to the results children get to. This is because children are still learning. Secondly, since they are at higher stages, which resulted in adapting to their behavior. To them it is more neutralize behavior. On the other hand, CBT has shown different results than what has been said previously in many cases. A study done by Dean Beebe, and Susan Risi proves that adolescents and older with Asperger’s require the same developing techniques which have been used with children and show same average of improvements as children show (369-401).

Procedure Summery

CBT has various types of therapies and also techniques mostly based on the methods or the goals each patient is trying to accomplish by the end of the session. CBT focuses on a major problem and divides it up into smaller sections, so it will be easier to help rehabilitate each patient separately and try to find the link between them for better results. Thus, these parts are usually broken down based on a specific situation into thoughts, emotions, physical feelings, and actions. For the actual situation, they focus on a specific problem in which the patient is showing difficulty with-for example, failing to know the emotional responses people whom they interact with are trying to show. To illustrate, a cognitive behavioral therapist would first ask the patient for his or her own thoughts of what is happening. Next they would move to the patient’s own emotions or is how they would explain what is happening around them. Following is their physical feelings or interpretations and whether the patient would respond to people’s emotional responses, and if they are appropriate. For instants, they might start shaking. Finally, what the patient’s behavioral responses to the event, and what would be in their mind a solution for the failing of understanding people’s emotional responses. For example, they may prefer to leave the people they have been interacting with who they could not understand. Since some patients have one of the areas affecting the other one, breaking them down can help track down where the therapist should start (“Royal College of Psychiatrists”).

Costs

In Addition, CBT has a much more long-lasting effectiveness, considering other types of treatments for Asperger’s syndrome patients. With CBT, the lasting of the treatment for an average patient can be from 6 months up to one year (Rucklidge 836-840). If we were to compare it with medications that a patient would have to take in a daily basis it would definitely be for a day, and the time, which the patient will need it again is unpredictable. So, in other words a patient on medication have to be under medication on a regular basis, whereas for a patient who have been attending CBT sessions, this is much less likely to happen. Moreover, the expenses of treatments can play a big role on this. With CBT patients can save a lot of money. For instants, for an adults with Asperger’s the most famous medication used by many ASD patients is Selective Serotonin Reuptake Inhibitors (SSRIs), which costs from 227 dollars to 500 dollars per month, and the grams differ from 10 grams up to 200 grams, and it needs to be taken one a day (“Consumer Reports Health Best Buy Drugs” 2,15). On the other hand, we have CBT, which typically would vary and offer wide range of number from 20 dollars up to 300 dollars per session. The average number of sessions is 6 to 11 and the effect of these sessions used last longer than any other medication.

Conclusion

In conclusion, cases similar to Adam Lanza are a result of failing to understand this group of the society, who have their special needs because they are un able to control their aggressive behavior. Providing them with CBT as a treatment can be one step forward to end violence that Asperger’s patients are not aware of. Since, CBT is very newly discovered treatment for Asperger’s syndrome, it helped a lot patients with Asperger’s to cope more with the disorder. CBT has many advantages in treating wide range of ages, and also in terms of showing long-term of effectiveness, and more importantly help patients with low incomes. In terms of development, CBT use varies techniques to provide best out comes and results to Asperger’s patients. Above all, CBT has focused on specific symptoms when treating Asperger’ for better understanding of the disorder and specifically each one of the patient’s symptoms. It also provides better results for patients at any stage of the disorder to end up with the most beneficial results. Currently, CBT is used to study Asperger’s, and hopefully this will a step forward to help all ASDs (Klin, and Volkmar).

References

“Asperger Syndrome: Guidelines for Assessment, Diagnosis, and Intervention.” MAAP. 01 Apr 2013: n. page. Print. <http://www.aspergersyndrome.org/About-Us.asp&xgt.

“Autism - Part I. (cover story).” Harvard Mental Health Letter. 17.12 (2001): 1-4. Web. 4 Apr. 2013.

Beebe, Dean, and Susan Risi. “Treatment of Adolescents and Young Adults with High-Functioning Autism or Asperger Syndrome.” Trans. Array Cognitive Therapy with Children and Adolescent. . 2nd Edition369-401. Web. 4 Apr. 2013. <http://www.drugs.am/upload/COGNITIVE THERAPY WITH CHILDREN AND ADOLESCENTS- MARK A. REINECKE 2006_1243921434031.pdf >.

“Cognitive Behavioural Therapy.” Royal College of Psychiatrists.rcpsych, Feb 2012. Web. Web. 4 Apr. 2013. <http://www.rcpsych.ac.uk/expertadvice/treatments/cbt.aspx >.

Cognitive Behavior Therapy News, . “Using Cognitive Behavioral Therapy to Treat Children with Asperger’s Syndrome.” Beck Institute Blog. Wordpress, 25 JUl 2011. Web. Web. 4 Apr. 2013.

Duckworth, Ken, and Jacob Freedman. “Cognitive Behavioral Therapy (CBT)?.” NAMI National Alliance of Mental Illness. NAMI, Jul 2011. Web. Web. 4 Apr. 2013. <http://www.nami.org/Template.cfm?Section=About_Treatments_and_Supports&Template=/ContentManagement/ContentDisplay.cfm&ContentID=141590 >.

Klin, Ami , and Fred Volkmar. “Asperger's Syndrome Guidelines for Treatment and Intervention.” Yale Child Study Center. the Learning Disabilities Association of America. Web. 3 Apr 2013. <http://childstudycenter.yale.edu/autism/information/astreatments.pdf >.

Rucklidge, Julia . “Successful treatment of OCD with a micronutrient formula following partial response to Cognitive Behavioral Therapy (CBT): A case study.” Journal of Anxiety Disorders. (2008): 836-840. Web. 4 Apr. 2013. <http://www.2ndchance.info/homemadediets-Rucklidge2009.pdf>.

Schleismann, Kelly. Gillis, Jennifer. The Treatment of Social Phobia in a Young Boy With Asperger's Disorder. Diss. Auburn University, 2011. 2011. Web.

Sexton, Connie. “Mental health experts seek clues behind killers.” Gannett 2013 (2012): n.pag. USA Today. Web. 4 Apr 2013. <http://www.usatoday.com/story/news/2012/12/15/mental-health-experts-seek-clues/1771513/>.

“The Antidepressants: Treating Depression Comparing Effectiveness, Safety, and Price.” Consumer Reports Health Best Buy Drugs. 2007: 2,15. Web. 4 Apr. 2013. < http://www.consumerreports.org/health/resources/pdf/best-buy-drugs/Antidepressants_update.pdf >.

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