Preface viii
Acknowledgments xvii
Important Notes xviii
1 What Asperger's Means for the Child 1
2 Meet the Parents 11
3 Beginning Th erapy 19
4 Hypersensitivity 29
5 Anxiety 43
6 Communication 61
7 Intellect, Cognitive Style, and Creativity 77
8 Feelings and Depression 101
9 Social Difficulties 121
10 Theory of Mind and Other So-Called Impediments to Therapy 147
11 Connecting It All 169
Appendix: Working with Parents 175
References 187
Author Index 201
Subject Index 205
About the Author 217
Richard Bromfiled, PhD, is on the clinical faculty of Harvard Medical School and maintains a practice outside Boston. He writes about children, psychotherapy, and family life for professionals and general readers. He is the author of Doing Child and Adolescent Psychotherapy Teens in Therapy, Nurturing the Self of the Child with Asperger’s , and Playing for Real.
Since Lorna Wing (1981) coined the term "Asperger's Syndrome" and
provided the first descriptions in English of the profile of
abilities of a child with Asperger's Syndrome, there has been an
explosion of recognition and interest about the condition,
resulting in hundreds of publications. Despite this explosion,
there are very few books available to guide the therapist in
designing and implementing psychotherapy for the child or
adolescent with Asperger's. Dr Richard Bromfield, a clinical
psychologist on the faculty of Harvard Medical School, has written
a book that exactly meets this need. With eloquence and empathy, Dr
Bromfield describes a new therapeutic approach for children and
adolescents with Asperger Syndrome and High Functioning Autism. To
inform his approach he draws from his clinical knowledge and wisdom
based on nearly 30 years experience, the current research and
clinical literature, and he illustrates his approach with many rich
case examples drawn from his own practice.
The approach described by Dr Bromfield [it]draws on and augments
the best of the current therapies utilized for Asperger's Syndrome,
including cognitive behaviour therapy, language therapies,
behaviour therapy and person-centred therapy. It is a
relationship-based, whole child approach, within which "what
matters most is what children with Asperger's think, feel, say, do
and experience" p. 1. Above all, Dr Bromfield advocates a
particular attitude toward people with Asperger's because he has
dis- covered that this attitude is a defining feature of successful
therapy with a person with Asperger's. The attitude is one of
respect, curiosity, enthusiasm, hopefulness, with a genuine focus
on strengths and growth. The therapist who is infused with Dr
Bromfield's vision would also be empirical, tenacious,
self-reflective, humble and wise. He or she would be wise in these
ways: open to new learning, able to incorporate this new learning
into therapy and nondefensive in the face of mistakes.
The specificity of Dr Bromfield's topic, his extensive clinical
experience, his knowledge of current research, and his skill as a
psychotherapist allows a depth of analysis about therapy with
children and adolescents with Asperger's that has not been offered
about this topic before. The companion volume for clinicians, equal
in richness of understanding about Asperger's would be: "The
Complete Guide to Asperger Syndrome" by Professor Tony Attwood
(2007). Dr Bromfield shows a deep understanding about Asperger's
syndrome, for e.g., his descriptions about the condition and his
topics for therapeutic intervention both begin with sensory
sensitivity, a crucial, but typically overlooked, area of
difference and suffering for the person with Asperger's. He points
out that "because they can be so hard to understand, children with
Asperger's get less understanding, empathy, admiring and
confirming—enormously less" p. 8. (my italics added). Dr Bromfield
is a clinician, on a voyage of discovery through unchartered
territory, drawing on 'pearls' of knowledge gained through the
current available research findings, and importantly, discovering
new 'pearls' and bringing them back for further analysis by both
researchers and therapists. It is an exciting journey and a true
testament to the scientist- practitioner model.
I can highly recommend this volume as a valuable addition to any
therapist's and parent's library. It is a much needed volume
because it[this book] not only brings together current knowledge
about Asperger's Syndrome, but also provides an excellent framework
for how to assist, including how to start therapy, how to help with
sensory sensitivities, anxiety, anger and depression, social and
communication dif- ficulties, how to use and understand intellect,
cognitive style, creativity, and 'theory of mind' in therapy; and
how to work with parents. Some therapists will feel confronted by
the advice "a therapist beginning with a child with Asperger's can
never go too slowly" p. 20, especially in these money-conscious
times, but we can take heart from the advice "... often, with
Asperger's, slow is the fastest route" p. 68. The volume is highly
readable and very moving, Dr Bromfield is an excellent communicator
and his heart is in his work. He exhorts us, as therapists, to
become involved, to try hard: that we do not have to be perfect or
to know everything, and that, with the right approach and attitude,
we have good reason to be optimistic about being part of a success
story for the child with Asperger's. (Journal of Autism and
Developmental Disorders) "Bromfield, who is a clinical
psychologist, skillfully shares with the reader the beneficial
knowledge that he has gained from his thirty years of experience in
working with this specialized population. The book is filled with
clearly conceptualized case examples that provide practical tips
and fresh insights for the benefit of children and families
impacted by Asperger's Disorder and high-functioning autism.
Bromfield's relationship-based approach to therapy with this
population is intended to be utilized in conjunction with other
widely recognized, evidence-based interventions for treating
children and youth diagnosed with autism spectrum disorders, such
as behavioral therapies, speech and language therapies, and social
skills training. As such, it is intended to supplement and to
mutually inform – rather than to supplant – these allied
approaches...[Bromefield] focus[es] the bulk of his discussion on
practical strategies for carrying out psychotherapy with children
with Asperger's within a context of "human connection and
understanding" (p. 174). Bromfield's therapeutic approach with this
population is a natural fit with social work's core value of
"meeting the child where she is" (p. xviii). Bromfield (p. 99) aims
to "see the child in his own completeness and reality" as he
details viable methods for encouraging children's unique talents,
skills, and predilections in a spirit of realistic optimism."
(Child and Family Social Work, August 2011)
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