DBT therapy for autism and teens? dealing with new diagnosis

[Anonymous]

I am having a bit of a struggle processing this diagnosis although it should not come as a surprise. I have a 16 year old who has ADHD and what was originally diagnosed a couple of years ago with social pragmatic disorder. new evaluation for college (he is a rising senior) and he met the criteria for autism. He is in counseling now (just started) with a DBT counselor. He has been in counseling before with regualr talk therapy. We have him in counseling due to his inability to manage frustration level, his hyperfocus on the negative where he gets so stuck that he can't see any way out of a bad situation and doesn't problem solve or figure out how to make his situation better and also his struggles to connect to people and recripocate in emotions, etc. The evaluator was not sold on the efficacy of continued therapy and also said that DBT would not be her first choice of therapy if we were to continue but it depends on the provider. Another wrinkle is that my kid does not seem to have insight on any of his challenges and just wants to terminate therapy all together. I am struggling a little bit with this diagnosis. He is the same person as he was yesterday but I guess my sadness comes from that it seems like the characteristics are so intractable with people who have autism but I know I need to educate myself more. He is otherwise fully integrated-great grades, AP classes, plays a sport (but doesn't have friends outside sport). Any insight would be appreciated.

[Anonymous]

Sounds like my teen son, in terms of challenges. Tho was diagnosed ADHD/ASD in 4th grade.
DBT helped for a but was not the most useful as he got older. DBT eventually felt like someone was telling him what to do and how exactly to cope, while also showing disinterest in the specifics of what actually was happening in his life and upsetting him. That was a bad mix, and resulted in an irritated, therapy-resistant kid.
Anxiety meds were most useful intervention (took the edge of the constant negativity and rumination). Also he eventually returned to regular talk therapy as a HS junior with a therapist that works with adults, who treated him like an adult, which he much preferred and was willing to go to.

[Anonymous]

DBT is over rated. Only works with highly motivated kids. And the actual protocol is that you have to do 3 rounds of it to meet the success levels seen in studies. That said if kid is motivated it can be very useful. Many therapists will teach some DBT skills but that’s not DBT.

[Anonymous]

PP is correct that your son does need to buy into DBT and sign a contract. That said, Capital Youth Services is actually doing work on ASD and DBT and the therapists there have been extremely helpful with our late ASD diagnosed teen.

[Anonymous]

NP. What would work better for an ASD teen who gets easily frustrated?