Autism spectrum disorders and various forms of mental illness can lead to difficulty in many areas of life. While functioning differently from the norm isn’t necessarily a bad thing, when it comes to things like self-care and safety, learning, limiting anxiety and interacting with others, everyone deserves help to achieve at the best of their capability.
Two types of treatment to improve how an individual functions are Applied Behavior Analysis (APA) and Occupational Therapy (OT).
ABA is a safe and effective way to help children and adults with developmental disabilities, learning disorders and mental illness learn various types of necessary skills. It has become a common approach to teach children on the autism spectrum. Based on strong scientific evidence since its development in the late 1960s, treatment approaches based on ABA are considered among the best for therapeutic and educational interventions for children with autism, and have value beyond autism.
There is some overlap between ABA and OT. Both are concerned with helping people gain, or regain, functionality in various areas. They also “borrow” classic features of each other to accomplish their goals of improving quality of life, and can complement each other in an integrated treatment approach.
Although people don’t typically think of OT as a mental health tool, its use is increasing in this area, particularly as part of a multidisciplinary approach to help people struggling with mental illnesses – including depression, anxiety, bipolar disorder and schizophrenia – to not be limited in living a full life. OT is not just for people experiencing physical limitations but also for those whose function has been restricted in some way by mental illness. According to the American Occupational Therapy Association, Inc., “Occupational therapy practitioners ask, ‘What matters to you?’ not, ‘What’s the matter with you?’”
The necessary assessments for ABA and OT typically differ based on their focus. ABA professionals analyze people’s behavior within the current environment to help them develop more adaptive responses to and within situations, while occupational therapy practitioners evaluate the person’s environment (home, school, workplace, etc.) to recommend adaptive equipment along with physical training.
OT is likely to involve changes in an individual’s personal environment to adapt it to their needs, while ABA emphasizes learning to adapt to the environment.
Because ABA is a form of cognitive behavior therapy focused on helping a person learn to respond and behave in various situations in different settings, it can be very helpful for people dealing with anxiety, particularly anxiety that triggers problem behaviors.
OT helps people develop healthy coping mechanisms to overcome the fatigue, apathy and anxiety that are typical of mental illness, while asking and assisting them to consider how they can change things by negotiating for accommodations from employers, teachers, etc.; looking for less stressful options for work or education; and finding resources like support groups. It also helps people assess their strengths and develop goals. (For a case study of how OT was implemented to help an ethnic-minority adolescent immigrant suffering psychosis, visit http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3171197/.)
OT and ABA treatments are tailored to meet the specific needs of individuals, so neither has standard protocol.
The core concepts of ABA can be implemented in an endless range of unique treatments. ABA uses positive reinforcement for desired behaviors and imposes consequences for display of undesired behaviors. From the most basic self-care skills, like brushing teeth; to understanding and participating in complex social situations, ABA has wide-ranging application. It’s more commonly used for children, and each course of treatment is based on observed behaviors, level of functioning, skills and abilities, and desired outcome.
For adults who need treatment for mental illness, OT is the more common approach, but it is also useful for children and adolescents, particularly in a group setting. To deal with mental health issues, particularly anxiety disorders, The American Occupational Therapy Association, Inc. advocates OT in group settings, and altering places, such as school cafeterias, which can cause undue anxiety. (For more information on this and other suggestions for how occupational therapists can assist in community mental health, visit http://www.aota.org/-/media/Corporate/Files/Practice/MentalHealth/Focus-On-Mental-Health-Booklet.pdf.)
Living with autism and mental illness can be challenging. Parenting a child on the autism spectrum, and helping loved ones of all ages with developmental disorders and/or mental illness can be also. But there are resources and useful treatment options to help you or your loved one. A holistic approach is best. ABA and OT can be vital tools within integrated treatment plans.
Melinda VanRy writes about mental illness and faith on her Fruit of Brokenness blog. She wants everyone to know they have inestimable worth, though she often fails to believe it for herself. Bouts of severe depression have nearly destroyed her but instead make her stronger and give her a desire to help others who struggle with mental illness and faith as she does. Melinda lives in New York with her husband, their three kids, and more cats than she ever wanted. If you’re thinking big city, don’t. The VanRy family makes their home in rural Central New York. Way closer to Canada than New York City. And not far from Lake Ontario, which she loves.
For further reading
ABA and Autism
ABA Resources: What is ABA?, The Center for Autism and Related Disorders (CARD)
http://www.centerforautism.com/aba-therapy.aspx
Applied Behavior Analysis: Overview and Summary of Scientific Support, Kennedy Krieger Institute
http://www.kennedykrieger.org/patient-care/patient-care-programs/inpatient-programs/neurobehavioral-unit-nbu/applied-behavior-analysis
ABA in Dual Diagnoses of Developmental Disabilities and Mental Illness
Functional Assessment and Mental Illness: An Interdisciplinary Approach to Intervention, NADD Bulletin Volume IX Number 1 Article 2
http://thenadd.org/modal/bulletins/v9n1a2~.htm
Occupational Therapy
About Occupational Therapy, The American Occupational Therapy Association, Inc.
http://www.aota.org/about-occupational-therapy.aspx#sthash.GG38J5G3.dpuf
OT and Mental Health
Ask an OT about Mental Health, Canadian Association of Occupational Therapists
https://www.caot.ca/default.asp?pageID=3627
Occupational Therapy’s Role in Community Mental Health, The American Occupational Therapy Association, Inc.
http://www.aota.org/about-occupational-therapy/professionals/mh/community-mental-health.aspx
Defying Shadows 