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Dear Beth,

I’m writing for advice about the therapy I already am doing. I like my therapist and it’s going well. But I’m having trouble remembering to do the things she recommends between sessions and then I feel like I’m disappointing her or not making progress. How do I keep up the work I’m doing in meetings with her between times I see her?

-Motivated But Stuck


Dear Motivated But Stuck,

What you’ve described is a common challenge for those in therapy, and I think it’s especially difficult if you have executive function barriers such as planning, memory, and initiation. But the good news is there are multiple ways to help you stay motivated and active in your personal changes between sessions.

One option that can be effective if you are a visual thinker is to create a visual representation either of your goal (if possible) or of what you want to work on between sessions. For example, if your goal is to start recognizing a cognitive distortion that you and your therapist have identified, you might draw or find an image that represents that distortion to you. My clients who use this technique also find it helpful to then hang that image somewhere where they’re guaranteed to see it once a day so they are reminded (e.g. “Oh, yeah, I should watch out for all-or-nothing thinking today.”). Some people can also make a sign with words with this same approach in mind if they are language thinkers.

If you find technology helpful, there are many apps that you can use to track moods and reinforce CBT or ACT skills and even more apps to help with various aspects of executive function. One in particular is called WoeBot. Currently WoeBot only works through Facebook Messenger so that can be a barrier for some people, but I have found it to be engaging and supportive of the ideas you are most likely already going over with your therapist as it’s an AI that is programmed with CBT (Cognitive Behavioral Therapy) skills. It also tracks mood and energy level, and encourages you to think about why you’re in a certain mood. Also, if you have a FitBit or Apple Watch, you can typically link those to calendar reminders or even to apps so you get a tactile reminder to work on the goal. You also can use reminder apps to send yourself encouraging reminders.

If you already use a planner, it can be helpful to write your goals into each week between sessions as that keeps them fresh in your mind, too. There also are planners and planner accessories that already have a goal structure built in.

It sounds like you have a good working relationship with your therapist, which is critical for success. However, if you find that she perhaps misunderstands some of the barriers you face that are unique to those with autism, AuSM's Counseling and Consulting Services is available for consulting.

Keep up the hard work of change!

-Beth
AuSM Counseling and Consulting Services
Dr. Amy Carrison, PsyD, LADC
Sara Pahl, MS, BCBA, LPCC, NCC
Dr. Jennifer S. Reinke, PhD, LAMFT, CFLE
Barbara L. Photo
Dr. Barb Luskin, PhD, LP
Beth Pitchford, LPCC
Pronouns she/her
Meg Benefield, MSW, LICSW
Pronouns she/her
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