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By: Zoe Chambers-Daniel, Taproot Therapy Clinical Trainee
Michael White, social worker and cofounder of narrative therapy eloquently said, “The most powerful therapeutic process I know is to contribute to rich story development.” Our lives consist of multiple stories starting from the moment we are born. These stories have power, giving us the motivation to pursue a specific career path, the openness to try new things, and the courage to persevere in the face of adversity. At the same time, the culmination of our life stories can also cause intense anxiety, preventing us from living a life that reflects our dreams and ambitions. Together Michael White and David Epston understood that the narrative we tell ourselves can influence our emotional wellbeing, therefore a therapeutic space should contribute to telling rich and productive stories about ourselves (White & Epston, 1990). Narrative therapy as a modality operates under these core principles: 1. You are the expert. In narrative therapy, you are given the space to share what is bringing you into therapy, and how your presenting concerns factor into multiple aspects of your life. There is no right or wrong way to express this to a professional. Once the narrative therapist is able to understand your narrative, collaborative work can begin to reframe the parts that are negatively impacting your wellbeing. 2. Your problems are external to your personhood. A common phrase of narrative therapy is “The person is not the problem. The problem is the problem.” Narrative therapy explores mental health symptoms, but does not explicitly use diagnoses. In this modality, you will learn to externalize your presenting concerns. Some people give their problems human characteristics, looking at the problem as if it has its mind of its own. When the external problem is given its own identity, you are less likely to feel shame surrounding your challenges. 3. Your social, cultural, and political context must be understood to understand your presenting concerns Your narrative does not exist without your socio-political context being discussed. It is the job of the narrative therapist to be curious about your identity, how your presenting concern exists in your specific context, and how goals can be established within that context (Ricks et al., 2014). Narrative therapy involves deconstructing unhelpful narratives, rewriting that narrative, understanding how the new narrative fits into your unique social context, ensuring the new narrative has the desired effects based on client feedback, and continuing to retell the story under the reconstructed identity (Dr. Todd Grande, 2016). This looks differently for everyone and with the support of a narrative therapist, you can assess what works best for you. Some techniques of narrative therapy include: 1. Exploratory Questioning Narrative therapists are interested in your past, present, and future. This involves asking questions about how the presenting problem influences you and how you influence others because of your concerns. What you see for yourself going forward is also important in creating goals that promote wellness. 2. Externalizing the Problem As mentioned previously, you will learn to externalize your presenting concerns. Not everyone gives their problem a name, but thinking of it as something outside of yourself is key to reducing shame and rewriting the narrative. 3. Creating Positive Stories It’s difficult to reframe a narrative that you have been telling yourself for your entire life. This is where the creation of positive stories comes in to help you see and be open to witnessing an alternative narrative. With a narrative therapist, you will be encouraged to look back on moments where you were proud of yourself or lived up to your values. This creates the foundation for a positive story that you can look to in relation to your unhelpful narrative. 4. Identifying Unique Outcomes a.k.a Sparkling Moments Sparkling moments in narrative therapy are helpful because they allow you to identify moments in your life that go against a negative narrative. Your strengths will be highlighted throughout the narrative therapy journey. 5. Creative Expression Narrative therapy offers opportunities to incorporate art, film, music, photography, writing, and other mediums of creative expression into the space (Ricks et al., 2014). Opening up the space to share creative work can be a sparkling moment on its own, and depending on your comfort level, it can be a regular part of sessions. 6. Inclusion of Supportive Family Members In circumstances where you have supportive family members that are involved in your journey towards mental wellbeing, involving them in narrative therapy can help in creating positive stories for you to hear about yourself. This is not a mandatory part of narrative therapy, but can play a significant role in reframing unhelpful stories. Narrative therapy is a great modality if you want to process the stories that make up your life, and need guidance in determining the usefulness of them. This modality promotes creative expression and autonomy in reshaping meaning making. References Dr. Todd Grande. (2016, January 21). Theories of Counseling - Narrative therapy [Video]. YouTube. https://www.youtube.com/watch?v=7HNw8LkTS68 Ricks, L., Kitchens, S., Goodrich, T., & Hancock, E. (2014). My story: The use of narrative therapy in individual and group counseling. Journal of Creativity in Mental Health, 9(1), 99–110. https://doi.org/10.1080/15401383.2013.870947 White, M., & Epston, D. (1990). Narrative means to therapeutic ends. New York, NY: Norton. By: Margot Gaggini, Taproot Therapy Clinical Trainee
Why Body Image Distress Matters Now In today’s world, young people are navigating constant messages about how they “should” look from on social media, in their friends groups, and even in well-intentioned conversations about “health.” In an international study of over 21,000 adolescents, 55% expressed dissatisfaction with their bodies and that rate was higher among those with greater social media screen time. Whether it’s a high schooler scrolling through TikTok or a college student adjusting to new routines and pressures, body image concerns can quietly shape self-esteem, relationships, and emotional health. What Body Image Distress Looks Like Body image distress isn’t always obvious. It can range from frequent negative self-talk (“I hate my stomach”) to avoidance behaviors (skipping social events or meals), or more serious patterns like disordered eating. Clinically, it often overlaps with anxiety, depression, and identity struggles. Recognizing these signs early and addressing them with empathy can make a significant difference. Three Therapeutic Frameworks That Help
Support starts with listening. Comments like “You’re beautiful, don’t worry about it” often minimize distress. Instead, try: “I notice you seem uncomfortable talking about your body, would you like to share what’s been hard lately?” Avoid focusing on appearance or food, and instead explore emotions and experiences. Collaborate on small realistic goals. If distress interferes with daily functioning like skipping meals, constant preoccupation, or self-harm thoughts, it’s time to seek professional help. Early intervention can prevent symptoms from deepening. Tools and Prompts to Try Right Now
Body image distress doesn’t have a quick fix, but compassion, curiosity, and connection go a long way. Whether you’re a parent, clinician, or student, remember that healing starts with understanding and not judgment. If you or someone you know is struggling with body image or related anxiety, Taproot Therapy offers a supportive space to explore these challenges. Reference: University of Waterloo. (2023, May 30). Study: Negative body image among teens a global issue. University of Waterloo News. https://uwaterloo.ca/news/media/study-negative-body-image-among-teens-global-issue-0 By: Allison Torsiglieri, Taproot Therapy Clinical Trainee
“I think it's just knowledge that everyone should have. That you have this amplifier… potentially linked to your pain, and your perceptions, or the fears, or the dangers around what might be going on in your body can contribute to that pain, or headaches, or anxieties, or probably all kinds of other things” (Tankha et al., 2023, p. 1588). Pain Reprocessing Therapy (PRT) is a promising new approach to treating certain types of chronic pain (Pain Reprocessing Therapy Center, n.d.-c). Even after a painful injury heals, the brain can get stuck in a pattern of sensing bodily harm or danger when there is none, and in response, trigger pain unnecessarily. This remembered pain, which doesn’t have a meaningful physiological cause, is called neuroplastic pain (Pain Reprocessing Therapy Center, n.d.-b). PRT helps us to better differentiate between dangerous and safe signals from the body, thereby reducing neuroplastic pain. My personal experience with PRT: I first heard about PRT on a podcast, and thought I’d give it a try as part of my own journey to tackle chronic back pain. While I haven’t mastered any of the techniques (described below), after reading The Way Out (a book on PRT, by its developer) I’ve noticed I feel less fear surrounding my back pain and more in touch with what is really going on in my body when I do feel this pain (Gordon & Ziv, 2021). This blog post is my way of sharing what I know about PRT, in case anyone reading might benefit from this model of therapy! How Does PRT Work? There are two main processes PRT uses to help reduce pain (Tankha et al., 2023):
What’s Involved in PRT? PRT uses psychological techniques to retrain the brain to interrupt neuroplastic pain. The main technique PRT uses is called somatic tracking. Somatic tracking is a practice in which we are experiencing our pain while simultaneously experiencing a sense of safety (Pain Reprocessing Therapy Center, 2021). Somatic tracking has three main elements (Pain Reprocessing Therapy Center, 2021):
Therapists trained in PRT also work with clients to process other sources of fear and stress in their lives, which can be contributing to a generalized sense of danger, and exacerbating their experiences of pain by way of the pain–fear cycle. “...I never would have guessed that childhood issues could be affecting the way I feel in my physical body today” (Tankha et al., 2023, p. 1588). How Can I Learn More About PRT? Here are some ways to learn more about PRT:
References Ashar, Y. K., Gordon, A., Schubiner, H., Uipi, C., Knight, K., Anderson, Z., Carlisle, J., Polisky, L., Geuter, S., Flood, T. F., Kragel, P. A., Dimidjian, S., Lumley, M. A., & Wager, T. D. (2021). Effect of Pain Reprocessing Therapy vs placebo and usual care for patients with chronic back pain: A randomized clinical trial. JAMA Psychiatry, 79(1), 13–23. https://doi.org/10.1001/jamapsychiatry.2021.2669 Fishbein, J. N., Schuster, N. M., Anders, A., Portera, A. M., & Herbert, M. S. (2025). Pain Reprocessing Therapy for migraine: A case series. Headache: The Journal of Head and Face Pain, 65(9), 1660-1665. https://doi.org/10.1111/head.15043 Gordon, A., & Ziv, A. (2021). The way out: A revolutionary, scientifically proven approach to healing chronic pain. Vermilion. Pain Reprocessing Therapy Center. (n.d.-a). Free recovery resources. https://www.painreprocessingtherapy.com/free-resources/ Pain Reprocessing Therapy Center. (n.d.-b). Neuroplastic pain. Retrieved October 9, 2025, from https://www.painreprocessingtherapy.com/neuroplastic-pain/ Pain Reprocessing Therapy Center. (n.d.-c). Pain Reprocessing Therapy. Retrieved October 9, 2025, from https://www.painreprocessingtherapy.com/ Pain Reprocessing Therapy Center. (2021). Treatment outline for Pain Reprocessing Therapy. https://www.painreprocessingtherapy.com/wp-content/uploads/2021/03/PRT-Supplementary-Materials-for-Site.pdf Sturgeon, J., Trost, Z., Ashar, Y. K., Lumley, M. A., Schubiner, H., Clauw, D., & Hassett, A. L. (2025). Brief pain reprocessing therapy for fibromyalgia: A feasibility, acceptability, and preliminary efficacy pilot. Regional Anesthesia & Pain Medicine. Advance online publication. https://doi.org/10.1136/rapm-2025-107076 Tankha, H., Lumley, M. A., Gordon, A., Schubiner, H., Uipi, C., Harris, J., Wager, T. D., Ashar, Y. K. (2023). “I don't have chronic back pain anymore”: Patient experiences in Pain Reprocessing Therapy for chronic back pain. The Journal of Pain, 24(9), 1582-1593. https://doi.org/10.1016/j.jpain.2023.04.006 By: Zoe Chambers-Daniel, Taproot Therapy Clinical Trainee
The availability of AI tools that are able to engage in a back-and-forth conversation and mimic human responses, is steadily growing. Tools such as ChatGPT, Replika, and Character AI can act as a personal assistant and a virtual companion all in one. Chat bot features are being used more as a support to cope with emotional distress, allowing us to disclose our mental health diagnoses and experiences of suicidal ideation to these tools. What does this mean for the decision making process in seeking out mental health care? Let’s start with the benefits. Using AI for emotional support gives us unrestricted access to something that listens and responds to what we type, and can create the feeling of being cared for (D’Alfonso, 2020). A key difference between human-human interaction and human-AI interaction is accessibility. AI does not get tired, and can continue a conversation until we decide to stop or pause. Many of us may feel safe talking to an AI tool because there isn’t a fear of judgment that exists in the same way when we are talking with another person face to face. We control the conversation and the environment. Imagine not having to leave your home to complete tasks or feel socially fulfilled! Although these benefits have impacted the daily lives of many, there are risks to using AI as a replacement for mental and emotional support services. The negative consequences of using AI for emotional support include the possibility of being too reliant on the tool, isolating ourselves from human companionship, and psychological distress from insufficient capabilities (De Freitas et al., 2023; Kalam et al., 2024). Being too reliant on AI to the point of isolation is connected to the benefit of having unrestricted access to it. This connection is important to think about through a culturally-informed lens. Marginalized communities who already feel isolated from the majority may use AI for support. Reliance is subjective with this growing development. De Freitas et al. (2023) identifies mental health risks that can form from using chatbots during a crisis and when we are seeking counsel in a vulnerable state. Companion AI from Cleverbot and Simsimi were analyzed, and the researchers found that the generative AI was usually unable to recognize signs of distress or when the user was hinting at intentions to self-harm. They also found that responses to distress were generally unhelpful. The AI either ignores the user’s distress, or provides encouraging commentary in response to suicidality (the user wishing they were dead, expressing intentions to harm themselves). Counselors and mental health professionals are thinking critically about AI use in mental health, weighing the benefits and drawbacks. Given the various effects identified, there is an aim to prioritize moderation when choosing to use AI tools and trying to seek out opportunities for human connection when possible (Alanezi, 2024). This does not in any way villainize AI or people who use it for companionship, but the distinction between human-human relationships and human-AI relationships needs to be acknowledged. If you or someone you know is seeking mental health support, please consider these points and resources: 1. Mental Health Professionals Are Here To Help Mental Health Professionals are able to consider your cultural context, assess your symptoms, provide empathy in a non-judgemental space, and create a treatment plan with you to support your journey towards emotional wellness. It can be scary to seek out help, and finding a professional may not be accessible for some. Keeping this in mind, there are professionals who are available to speak on the phone with you when you are in crisis. If you would like assistance finding support from a therapist who is a good fit for you, visit our Contact page, or reach out to [email protected]. 2. The Risk and Benefits of Using AI Depend on Your Unique Life Context The risks and benefits listed in this blogpost are not exhaustive. They are meant to accompany your examination of the utility of AI for mental health purposes. Please consider your own background and context, and what works best for your specific situation. Using chatbots may be your only accessible way to receive some support, and that’s okay. 3. Mental Health Wellness is a Journey We are not at a point where AI can be considered an appropriate replacement for mental health professionals. It can be a tool, however, in supporting that journey. Because wellness is a journey, remember to be kind to yourself when you are making decisions for your care. 988 Suicide & Crisis Lifeline The 988 Suicide & Crisis Lifeline connects you to trained crisis counselors 24/7. They can help anyone thinking about suicide, struggling with substance use, experiencing a mental health crisis, or any other kind of emotional distress. You can also call, text or chat 988 if you are worried about someone you care about who may need crisis support. OASAS HOPEline New York State’s 24/7 problem gambling and chemical dependency hotline. For Help and Hope call 1-877-8-HOPENY or text HOPENY Domestic Violence If you or someone else is in a relationship is being controlled by another individual through verbal, physical, or sexual abuse, or other tactics, please call: 1-800-942-6906 The Trevor Project 24/7 crisis services for LGBTQ+ people: 1-866-488-7386 References Alanezi, F. (2024). Assessing the effectiveness of CHATGPT in delivering mental health support: A qualitative study. Journal of Multidisciplinary Healthcare, Volume 17, 461–471. https://doi.org/10.2147/jmdh.s447368 Crisis prevention. (n.d.). https://omh.ny.gov/omhweb/bootstrap/crisis.html D’Alfonso, S. (2020). AI in mental health. Current Opinion in Psychology, 36, 112–117. https://doi.org/10.1016/j.copsyc.2020.04.005 De Freitas, J., Uğuralp, A. K., Oğuz‐Uğuralp, Z., & Puntoni, S. (2023). Chatbots and mental health: Insights into the safety of generative AI. Journal of Consumer Psychology. (John Wiley & Sons, Inc.), 1. https://doi.org/10.1002/jcpy.1393 Kalam, K. T., Rahman, J. M., Islam, M. R., & Dewan, S. M. R. (2024). ChatGPT and mental health: Friends or foes? Health Science Reports, 7(2). https://doi.org/10.1002/hsr2.1912 By: Zoe Chambers-Daniel, Taproot Therapy Clinical Trainee
People in the autistic community often experience social communication challenges, engage in restrictive/repetitive behaviors, and can feel overwhelmed by certain environmental stimuli (American Psychiatric Association, 2013). An autistic individual who has trouble engaging in conversation, interpreting facial expressions, participating in social events meant to build community, and absorbing harsh stimuli (such as lights, crowded spaces, multiple voices talking at once) can have a hard time forming and maintaining friendships with their neurotypical peers. A common myth about autistic people is that they prefer to be alone, when in fact many people on the spectrum desire social connection. Their social needs may, however, look different, which can often lead to misunderstandings. When asked what friendship means to them, autistic individuals that participated in research shared that friends share their interests, understand them as someone with different needs, and look after them. At the same time, autistic individuals may also perceive friendships as tiring because of the pressure to conform to neurotypical norms and mask their autistic traits (Black et al., 2024). When autistic people feel seen and understood, they report decreased feelings of loneliness (Mazurek, 2014; Sosnowy et al., 2019). Finding community can be difficult whether or not an autistic person wants friendship with someone of the same neurotype. Here are some considerations when pursuing new friendships in a neurodivergent affirming framework: 1. Connect through shared interests It can be difficult to start conversations with people you don’t know. Having an idea of what someone’s interests can make this task easier, especially if you share those interests! Consider joining groups or clubs focused on your favorite activities. 2. Be direct & honest Misunderstandings and conflict resolution are a normal part of friendship. It’s important to express your needs and preferences clearly! Some friends are great at providing distraction when you are feeling upset, and others are great at talking through a specific problem that you are having. Making it clear what you need from a specific friend and the qualities that are important to you can help you find your community. 3. Set clear boundaries Everyone has different energy levels and expectations of what activities are considered “fun.” Having a conversation with someone you are interested in bonding with about what situations typically lead you to feel overwhelmed and what typically helps you in those moments can help them understand your needs. It is also important to ask them what they need as well. 4. Prioritize authenticity Prioritizing authenticity can be difficult to do when there is a pressure to mask your neurodivergent traits. Friends that accept who you are and understand your needs make it easier to be yourself! Conforming to neurotypical standards can make you feel more lonely even when you are around others, so it’s important to keep in mind that good friends won’t make you feel bad about who you are. Thinking about friendship and what makes someone worth connecting with is a personal and unique experience. In exploring social connection needs, remember to be kind to yourself. There are different types of friendships, and the ones that don’t conform to neurotypical standards are just as valid. References American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). https://doi.org/10.1176/appi.books.9780890425596 Black, M. H., Kuzminski, R., Wang, J., Ang, J., Lee, C., Hafidzuddin, S., & McGarry, S. (2024). Experiences of friendships for individuals on the autism spectrum: A scoping review. Journal of Autism and Developmental Disorders, 11(1), 184-209. Mazurek, M. O. (2014). Loneliness, friendship, and well-being in adults with autism spectrum disorders. Autism, 18(3), 223-232. Sosnowy, C., Silverman, C., Shattuck, P., & Garfield, T. (2019). Setbacks and successes: How young adults on the autism spectrum seek friendship. Autism in Adulthood, 1(1), 44-51. By Lulu Lyle, Taproot Therapy Clinical Trainee
Dialectical Behavior Therapy (DBT) is based on the idea of radical acceptance, which means that people can both accept that “it is what it is,” but also work to change their behaviors for a desired outcome. In other words, one can validate the thought or feeling and still make change. It aims to arrive at the truth by exchange and synthesis of logical yet opposing arguments. Simply put, it is holding two truths at once. DBT was originally developed as the gold-standard treatment for individuals with Borderline Personality Disorder (BPD); however, it can also be effective for a broader range of clients, including those experiencing anxiety, depression, substance use issues, emotional dysregulation without high risk. There are four main skill modules of DBT: mindfulness, distress tolerance, interpersonal effectiveness, and emotion regulation. These main areas help to manage emotions, behaviors, and relationships. Mindfulness Mindfulness is “paying attention in a particular way: on purpose, in the present moment, and nonjudgmentally" (Kabat-Zinn, 1994). DBT aims to teach clients the skills to build awareness and respond thoughtfully to their internal and external worlds. Some key skills to build include how to observe, describe, and participate intentionally. Distress tolerance Distress tolerance is “an individual’s perceived or actual ability to withstand negative emotional and/or other aversive states”(Simons & Gaher, 2005). In DBT, the client will learn skills to remember what to do in emotionally distressing situations. For example, one can focus on building skills to calm their nervous system down, like self-soothing techniques. Distress tolerance focuses on the importance of practicing radical acceptance through saying things to yourself like: I accept it as it is. I can’t change the past. I can only control the present. Interpersonal effectiveness Interpersonal effectiveness is how to “attend to relationships, balance priorities versus demands, balance the 'wants' and the 'shoulds,' and build a sense of mastery and self-respect in relationships” (Linehan, 2015). The interpersonal effectiveness skill module focuses on developing skills to build and maintain healthy relationships. DBT includes skills that teach clients how to assert themselves in terms of asking for something or saying no. Additionally, it includes skills for how to maintain and take care of relationships. Emotion regulation Emotion regulation refers to “the processes by which individuals influence which emotions they have, when they have them, and how they experience and express these emotions” (Gross, 1998). The emotion regulation aspect helps clients understand and manage their emotional responses. There are DBT skills that help clients focus on the foundational parts of health that have to do with one’s own body because it is hard to help the mind when the body is also not functioning properly. Additionally there are tools such as “opposite action,” which explains how sometimes clients should respond to an emotion with a behavior opposite to its impulse. Lastly, the client will learn skills to reduce the tendency to vacillate between extreme expression and complete suppression. If you find yourself wanting to improve your mindfulness, distress tolerance, emotional regulation, and/or interpersonal effectiveness, DBT may be the best type of therapy for you! Overall you will learn to:
By Zoe Chambers-Daniel, Taproot Therapy Clinical Trainee
The term "microaggression" was identified by psychiatrist and Harvard professor Chester M. Pierce. Defined as “subtle, stunning, often automatic, and nonverbal exchanges which are put-downs of blacks by offenders,” microaggressions perpetuate racist and discriminatory acts that hurt the black population over time (Pierce et al., 1977). The present understanding of microaggressions expands to all marginalized populations. There are many ways that these indirect actions can manifest. Common examples of microaggressions are perpetrators asking “Where are you really from?” when talking to someone with a marginalized racial/ethnic identity, making hurtful jokes based on someone’s identity, and invalidating experiences that the marginalized person has been hurt by (Sue et al., 2007). Although many people who commit microaggressions against marginalized communities are not always consciously aware of the impact of their words and actions, harm is still caused. Microaggressions that add up negatively impact an individual’s emotional and mental wellbeing. The invalidation, harmful language, and erasure of experience cannot always be addressed because of the subtlety. This can leave an individual feeling helpless. Because microaggressions can be a constant in some people’s lives, it is important to practice self care in response to the harm. Consider these tips to practice wellness in your experience of microaggressions: 1. Address the microaggression directly If you know that you are in a safe environment to have a conversation with the person that committed a microaggression, addressing the harm directly can be useful. If the microaggression was in the form of a joke, asking the individual to explain the punchline encourages them to think about what was said. An example of this is, “I don’t understand what is funny. Can you explain what you just said?” If someone makes an invalidating comment, sharing that what was said was hurtful can also be a way to address the harm and encourages the perpetrator to think about the impact of their actions despite having good intentions. 2. Prioritizing Physical Health Your physical and mental safety is important! It isn’t always safe to address someone directly and protecting yourself should come first. Furthermore, you may not always have the energy to educate someone on your identity and the implications of their actions. Instead, taking care of yourself in response can look like getting enough sleep at night and eating throughout the day to nourish yourself. Remember that taking care of yourself in the context of experiencing microaggressions can look differently for everyone. 3. Community Bonding Microaggressions attack an aspect of your identity, and a way to recover from that is spending time with your community. Whether as a form of distraction, intentional discussion of discrimination, or somewhere in between, community can heal. This community does not have to share your identity that was attacked, but should include people you feel safe with and that want what is best for you. 4. Personal Processing & Reflection Microagressions can be so subtle that they are hard to share with others, so it is important to take the time to personally reflect on your feelings. This can be done in different ways. Journaling is a practice that encourages self reflection and can be a way to explore how microaggressions affect self-esteem and connection to your identities. Creative arts expression such as dancing, singing, painting, crocheting and many other methods can also be a way to process the experience without assigning words to it. Microaggressions have a profound impact on all domains of wellbeing. Remember that your identities deserve to be respected. Unfortunately, that can’t always be guaranteed so it is important to practice self care in response. References Pierce, C. M., Carew, J. V., Pierce-Gonzalez, D., & Wills, D. (1977). An experiment in racism. Education and Urban Society, vol. 10, no. 1, pp. 61–87. https://doi.org/10.1177/001312457701000105. Sue, D. W., Capodilupo, C. M., Torino, G. C., Bucceri, J. M., Holder, A. M. B., Nadal, K. L., & Esquilin, M. (2007). Racial microaggressions in everyday life: Implications for clinical practice. American Psychologist, 62(4), 271–286. https://doi.org/10.1037/0003-066X.62.4.271 By Zoe Chambers-Daniel, Taproot Therapy Clinical Trainee
Autistic burnout is a unique experience separate from the common definition of burnout. While the latter describes a state of running on empty from continuous exposure to heavy workloads without proper rest, the former is “a syndrome conceptualized as resulting from chronic life stress and a mismatch of expectations and abilities without adequate support. It is characterized by pervasive, long-term (typically 3+ months) exhaustion, loss of function, and reduced tolerance to stimulus” (Raymaker et al., 2020). Autistic burnout is exclusive to individuals on the autism spectrum who have ranging support needs based on unique social communication challenges, sensory sensitivities, and restricted interests. Masking, the ability to suppress autistic traits, can be a cause of autistic burnout and can exacerbate the effects long-term. Experiencing pressure to say yes to social obligations, self-censoring during conversations to fit the group’s “norms,” and suppressing safe self-stimulatory behaviors are some examples of masking. Unmasking is not always a safe option depending on the social context and can be challenging to start doing when masking is a part of daily life. The autistic population can experience burnout in many ways. During this state, sensory stimuli may feel harsher and individuals can have lower tolerances for bright lights, loud spaces, and intense smells. Social engagements that were enjoyable before burnout may seem obligatory during burnout. The profound exhaustion can make masking harder, which can significantly impact present relationships. Support is crucial during periods of autistic burnout. Although it can be challenging finding long periods of rest, there are small ways to accommodate yourself. These are a few tips to prevent autistic burnout and some techniques to mitigate the exhaustion effects if you are currently experiencing it: 1. Pursue Special Interests Engaging in special interests can bring immense joy, especially when it can not be accessed in workplace/school environments. Whether your interests include consuming media (e.g., film, television, comic books), collecting objects, or making things, consider scheduling intentional time to participate in it throughout the week. 2. Incorporate Breaks into the Day Taking breaks, especially when you feel like you are in a productive zone, may not be something you realize you need. Having visual aids in the workplace/home that remind you to take a break can be helpful. Specificity regarding water, using the bathroom, and eating a meal can replenish your energy between tasks. 3. Setting Boundaries It is important to set boundaries as a form of taking care of yourself. Saying no to social events that you don’t have the energy to attend, finding intentional community with other neurodivergent people, and communicating the type of company you need is a great way to accommodate yourself. 4. Sensory Care To soothe yourself somatically, you can apply deep pressure by using weighted blankets or asking someone you are comfortable with to provide a 20 second hug. Lighting candles that carry your favorite scent can be a relaxing sensory experience as well. Using fidget toys to stim safely can be beneficial during work, school, and social engagements. Moving your body through rocking, swinging, and/or dancing can also be ways you self-soothe. In implementing these tips, remember to be gentle with yourself. Finding ways to self-soothe, set boundaries, take breaks, and incorporate interests during a period of profound exhaustion is a difficult task. The support that you provide yourself is valuable. References Raymaker, D. M., Teo, A. R., Steckler, N. A., Lentz, B., Scharer, M., Santos, A. D., Kapp, S. K., Hunter, M., Joyce, A., & Nicolaidis, C. (2020). “Having all of your internal resources exhausted beyond measure and being left with no clean-up crew”: Defining autistic burnout. Autism in Adulthood, 2(2), 132–143. https://doi.org/10.1089/aut.2019.0079 By Lexi Campbell, MSW, Psychotherapist
Women (cisgender, trans women, and other female-identifying individuals) are often diagnosed with Autism Spectrum Disorder (ASD) later in life as compared to cisgender men. Researchers have cited that cases of undiagnosed Autism may be as prevalent in the population as diagnosed Autism, with female-identifying individuals being particularly vulnerable to late or missed diagnoses (Belcher et al., 2022). The vulnerability to late diagnosis among women can be traced back to foundational research on ASD, which focused on young cisgender boys and led to a skewed understanding of its presentation— which, in turn, contributed to gaps in knowledge among clinical diagnosing professionals (Belcher et al., 2022; Price, 2022). There is now strong evidence indicating differences in Autism presentation as it relates to gender; female-identifying individuals tend to exhibit higher-than-expected social functioning and more prevalent social masking or camouflaging behaviors (accompanied by higher levels of social distress, such as loneliness), show less clearly visible behavior differences, demonstrate more inward-focused emotional challenges, and often experience greater difficulties with sensory sensitivity (Belcher et al., 2022). In a study conducted by Kentrou et al. (2024), researchers also found that one in three Autistic women reported at least one misdiagnosis before being accurately diagnosed with ASD, with Autistic women also reporting misdiagnoses more frequently than Autistic men. Late diagnosis and persistent misdiagnosis of ASD among women have been linked to greater mental health challenges later in life (Price, 2022). With this in mind, Taproot Therapy is facilitating an online support group specifically designed to address the needs of adult women on the spectrum. Led by a neurodivergent affirming clinician, this online therapeutic space will support group participants in exploring their unique experiences of Autism, facilitate collaboration on their specific support needs, help them gain Autism-specific coping tools, support a reduction in feelings of shame and guilt associated with their neurotype, and foster authentic connections with others who understand their journey. This 8-week group provides participants with a supportive community that encourages self-discovery, connection, and growth. Please see the agenda outline below for additional details. Program Outline: Week 1: My Autism Journey We begin our journey together by talking about your experiences with diagnosis or self-diagnosis and identifying your goals for this time together. Week 2: Know Thy Autism Discussion on the ASD brain, identifying your unique Autism strengths, and identifying your needs. Week 3: Sensory Sensitivity Solutions We talk all things sensory and explore what coping tools may be helpful in times of sensory overload. We learn about body scanning for sensory needs. Week 4: ASD & Masking Exploring Autistic masking and related challenges, as well as unmasking. Week 5: Seeking Autistic Joy Discussion on your special and creative interests that make you, YOU! We lean into finding restorative joy in our special interests. Week 6: May I Be Kind to Myself We dive into the challenges of living in a neurotypical-oriented world, and how to tackle our inner critic and those challenging “I shoulds.” Week 7: ASD Burn Out & Prevention Education and discussion on Autism Burnout. We design a burnout prevention plan that is unique to your needs. Week 8: Final Reflections Guided discussions on how to continue to support yourself moving forward and how to apply all that you’ve learned. Groups will take place on Tuesday evenings at 7:00PM via telehealth. Each meeting will be approximately 60 minutes in length. The group is scheduled to start Tuesday, July 15th at 7:00PM. If you are interested in learning more, or if you would like to reserve a spot, please reach out to [email protected] or [email protected] today! References Belcher, H.L., Morein-Zamir, S., Stagg, S.D. & Ford, R.M. (2022). Shining a Light on a Hidden Population: Social Functioning and Mental Health in Women Reporting Autistic Traits But Lacking Diagnosis. Journal of Autism and Developmental Disorders, 53, 3118-3132. http://doi.org/10.1007/s10803-022-05583-2 Kentrou, V., Livingston, L.A., Grove, R., Hoekstra, R.A. & Begeer, S. (2024). Perceived Misdiagnosis of Psychiatric Conditions in Autistic Adults. eClinical Medicine of The Lancet Discovery, 71 (102586). DOI: 10.1016/j.eclinm.2024.102586 Price, D. (2022). Unmasking Autism: Discovering the New Faces of Neurodiversity. Harmony Books. By Lulu Lyle, Taproot Therapy Clinical Trainee
Having ADHD doesn’t excuse “bad behaviors,” however it can explain why some children struggle with them. Attention deficit/hyperactivity disorder, also known as ADHD, can lead to a myriad of ongoing problems related to having a hard time balancing attention, being hyperactive and impulsivity. Oftentimes, children with ADHD also have low self esteem, difficulty in relationships, and poor performance in school. While ADHD is a complex disorder with many facets, there are three general types of ADHD: predominantly inattentive, hyperactive and impulsive, and combined.
It is important to understand which type of ADHD your child has in order to help manage their symptoms most effectively. While ADHD can contribute to undesirable behavior, here are some ways in which caregivers can help their child stay on task, follow the rules, and improve behavior overall. 1. Create a Structured Environment: Organize the environment: Establish designated areas for homework, reading, and relaxation to minimize distractions. Use visual aids: Checklists, visual timetables, and sticky notes can help with organization and task completion, as many people with ADHD respond better to visual cues than to auditory ones. For example, having a morning routine checklist on the fridge to be filled out every morning. Establish routines: Plan the day with clear expectations and predictable rituals for meals, homework, and bedtime. Even further, set alarms to signal your child to move on to the next task during the morning or nighttime routine. 2. Break Down Tasks and Set Expectations: Divide tasks: Large tasks can be overwhelming. Break them into smaller, more manageable steps, which we sometimes call “chunking.” For example, instead of “clean your room,” it can be more manageable to focus on one area at a time, like “clear off your desk.” Another example of this is making the bed, which may seem simple, but when you break it down, there are many steps involved! 1. Strip the bed 2. Take fresh sheets out of the closet 3. Put the fitted sheet on the bed 4. Put the top sheet on the bed 5. Put the blanket on the bed 6. Add any pillows or stuffies to the bed. Focusing on one task at a time can be helpful for those struggling with executive dysfunction. Be clear and consistent: Children with ADHD need clear, consistent expectations and directions. Example: In a two parent household or when coparenting, make sure both parents on the same page about discipline (i.e. how many warnings are given, reward systems, etc) Set limits and consequences: Implement an effective discipline system that teaches appropriate behavior and follows through with consequences. More on consequences: If taking away a privilege is not working, you could try a “reward” system for a positive change in behavior. This could be in the form of verbal praise, privileges, or small gifts. Additionally, lean into the lesson of natural consequences; if your child is not in a dangerous situation, it may be worthwhile to explore the natural consequences of their actions. You may find that they might have a greater impact than consequences that came from you. For example, if you ask your child to pack their favorite snack for the next day multiple times, but they do not listen to your instructions, then they will not be able to enjoy that food at lunch time. 3. Manage Triggers and Emotional Regulation: Identify triggers: Look for signs of frustration or overstimulation. A way to do this is by keeping a journal log to note places or situations when symptoms seem to be heightened. This log should include lifestyle factors like sleep, nutrition, and technology use, as well as emotional triggers like relationship conflicts, criticism, or perception of failure. Teach them coping mechanisms: One example of a coping mechanism is to find other outlets to get the energy out. Your child might respond to signing up for extracurricular activities like sports or clubs that involve outdoor activities. Additionally, you can help your child learn stress management techniques like deep breathing exercises. Communicate openly: Talk with your child about their feelings and experiences to foster a sense of understanding and support. Explain why you’re frustrated and ask what is challenging or difficult for them as well. Remember that your child often hears how you communicate about their ADHD to others, so be mindful of the language you are using. It is important to acknowledge your child’s strengths and successes to help foster a positive self image. If you feel you or your child would benefit from the support of a therapist to help manage their ADHD, don’t hesitate to reach out to [email protected] for a consultation! |
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