Adapting therapy and counselling in autism: notes for professionals

Principles of interaction

According to the guideline, people with autism have individual skills and needs that should be taken into account in interaction. Helpful in particular are ^{[1, Rec. 3]}:

• the possibility of non-verbal initiation of contact,
• concrete, direct communication that matches developmental age,
• structuring the environment and sequences of actions (for example through visual means, predictability and consistency of people),
• maintaining physical distance,
• avoiding strong sensory stimuli such as noise, smell and light.

A discrepancy between cognitive skills and social or daily-living skills should be taken into account. Under- or over-demand in everyday demands and set therapy goals should be avoided. ^{[1, Rec. 3]}

Joint decision and case management

• Inform in detail. People with autism and their families should be informed in an understandable way about treatment options, support options, legal requirements and entitlements. A joint decision-making process should take place in which the needs and preferences of the person and, in the child and youth area, also of the legal guardians are taken into account. ^{[1, Rec. 6]}
• Risks, benefits, time limit. For children and adolescents, the risks and benefits of a measure and its time limit should be discussed with the legal guardians (and, depending on age, with the child), including the question of whether the treatment suits the whole family including siblings. ^{[1, Rec. 6]}
• Adults: The approach should be individualised and appreciative and take into account independence and any care situation. ^{[1, Rec. 6]}
• Plan progress together. In principle, it should be planned together how progress is evaluated. ^{[1, Rec. 6]}
• Coordination. Care measures should be coordinated, linked and aligned by a single point to avoid gaps, duplication and ineffective or harmful interventions. Case management should only be carried out by a licensed professional; transition phases (for example nursery–school, school–work) should be accompanied. ^{[1, Rec. 6]}

Competences and supervision

According to the guideline, all people in the health and social system who work with people with autism should, among other things, bring three things. They should have sound, scientifically based knowledge of the condition and of the needs of those affected and relatives. They should know the possibilities of medication and of part-inpatient or inpatient treatment. They should also have sound practical skills in effective behaviour-therapy methods and structuring measures. ^{[1, Rec. 7]} All therapists should be supervised regularly by experienced, licensed therapists; the correct implementation of effective methods should be checked regularly. ^{[1, Rec. 7]}

What else you can bear in mind as a professional

• Advice for those affected and families on therapy and support: Support in autism: overview.
• Psychotherapy for co-occurring conditions (anxiety, depression) with adaptations: Psychotherapy in autism.
• Nursery: Autism in nursery: notes for professionals.

Sources and literature

1. DGKJP, DGPPN et al. Autismus-Spektrum-Störungen im Kindes-, Jugend- und Erwachsenenalter. Teil 2: Therapie. S3-Leitlinie, AWMF-Reg.-Nr. 028-047, Stand Text 02.05.2021 (Empf. 3, 6, 7). – Guideline (in German); expired on 23 March 2026 (see no. 2)
2. DGKJP. Aktuelle Leitlinien (Eintrag 028-047: „Gültig bis 23.03.2026“). https://www.dgkjp.de/wissen/aktuelle-leitlinien/ – Professional society (website in German)