Interview between Speaker 1 (Meg Ferrell), Speaker 2 (Sharon Hammer), and Speaker 3 (Lisa Hoeme)
Episode 86: Trauma-Informed Practices for Your Neurodivergent Clients
[Introductory music]
Welcome to the Two Sides of the Spectrum Podcast. A place where we explore research, amplify Autistic voices, and change the way we think about autism in life, and in our professional therapy practices. I’m Meg Ferrell, formerly Meg Proctor, from learnplaythrive.com broadcasting to you today from unceded Tsalagi territory.
Meg:
Before we get started, a quick note on language. On this podcast, you’ll hear me and many of my guests use identity-affirming language. That means we say ‘Autistic person’ rather than ‘person with autism’, because this is the preference of most Autistic adults. Being Autistic is a part of their identity that they don’t need to be separated from. Join us in embracing the word ‘Autistic’ to help reduce the stigma.
Welcome to Episode 86 with Sharon Hammer and Lisa Hoeme on trauma informed care. Trauma informed care has become such a buzzword, but there’s often so little content behind it. I remember being a newer OT looking to really support my clients’ felt sense of safety, but I just couldn’t conceptualize what it would mean or look like to do that without some sort of training. So, I found a continuing education course. It was put on by an OT, so I was hoping that would mean it would be really relevant and applicable to my work. And somehow five or six hours later, I hadn’t really learned anything that would impact how I supported my clients in my work. Fast forward to 2023, I came across the work of licensed professional counsellors, Sharon Hammer and Lisa Hoeme. They both teach and train providers as well as supporting their own clients in really creative trauma informed ways in their practice in Wisconsin, which is called Imagine Your Capacity. Their teaching on trauma informed care wasn’t just practical, it was very intentionally woven into an understanding of neurodiversity and intersectionality in a way that I haven’t seen in very many places. So, today’s podcast episode is a really great place to start if you want to deepen your understanding of trauma informed practices in the context of neurodiversity-affirming care.
And if you want to really dive deep into how to set up your sessions, how to communicate with your clients, how to set up your environment, and even how to write goals to support your client’s sense of safety, we also have a brand new seven-and-a-half-hour self-paced continuing education course called ‘Trauma Informed Therapy for Autistic People’. It’s taught by Sharon and Lisa. The waitlist is now open, and pre-registration will open soon. That’s when we offer the lowest price we’ll ever offer right before the course launches. So, check it out and get on the list at learnplaythrive.com/trauma. Here’s the interview with Sharon Hammer and Lisa Hoeme.
Hi, Sharon. Hi, Lisa. Welcome to the podcast.
Sharon:
Hi, Meg.
Lisa:
Thanks, Meg.
Meg:
I’m so glad to sit down with y’all. I told you before we started that I’ve been watching through your new course. So, I’ve been sitting at my computer looking at your faces for seven hours. But not with you able to see me and interact. So, it’s a pleasure to be here in real time with you.
Sharon:
We appreciate that so much, Meg, when you said that. Like, that is a lot. That’s a lot of time to be to be looking at us and spending time with us. And we’re so happy to be able to be with you and have a dialogue today. That’s lovely.
Meg:
Well, I obviously enjoyed it so much that I asked you for more time to sit down and talk about this topic, because it’s so important. And I want to start out by letting listeners get to know you and your story a little bit. Can you each tell us a little bit about your story of how you came to do the work that you’re doing?
Sharon:
Yes, I will. I’ll start that, Meg. I can absolutely do that. So, I was getting my master’s degree. So, I was getting my master’s degree in counseling. And as we all know, graduate school can be very expensive. And so, I was looking for a part-time job while I was in school. And I took a job. And I do have to, before I tell the story, I do have to say that this job that I took was in ABA. So, I do feel like that is a trigger warning sometimes. I absolutely want to acknowledge that and say that as I’m getting into this story. And so, I took a part-time job providing ABA therapy for a couple of Autistic children that — we’re from Wisconsin, Lisa and I are from Wisconsin. And at that time, that was the only treatment intensive, in-home treatment, that was provided financially by the state. And so, while I was in grad school, I got this job. And what happened to me while I was in that job is I just kind of fell in love with the kids. I just would, I would go to bed and I would dream about — I worked with two little boys. They were both about four or five. And I would go to bed and I would dream about them in my sleep. And it just like, I don’t know what it was, but it just kind of made a connection with me, like, deep level. Of course, this wasn’t what I was going to grad school for. And so, I graduated grad school. My emphasis was in marriage and family work. And so, I thought I should actually do that. And so, I went and did in-home court mandated marriage and family therapy work for a year because I thought that’s what you’re supposed to do after you graduate with this. And I missed the Autistic people so much, that when I — probably less than two years, probably about 10 months in. And I saw an ad in the paper to work with Autistic people again, and I jumped at the opportunity. And I was like, this is what I want to do and this is where I’m supposed to be. And so, that was a long time ago, that was probably in about 1998, I want to say, and I’ve been in the field ever, ever since. So, that’s my background. So, I’m still a therapist. I’m an LPC. In Wisconsin, we have licensed professional counsellors. And so, that’s what I am. And my specialty area is neurodivergence and mental health.
Meg:
Sharon, before we switch over to Lisa’s story, can you speak a little bit more to how your practice evolved from starting out in ABA to where you are now?
Sharon:
Yes, I actually love telling the story. So, thanks for asking. You know, when I first got into this field, I didn’t know a lot about autism at all. And so, I think that when I studied in grad school, we did not have a course on autism at all. I was already, because of my assigned work, I was seeking it out. And so, if we had like projects we could do, I would choose books on autism and talk to, you know, talk to Autistic people. And what happened was getting back into the field, you know, at that point, and we are talking over 20 years ago now, I looked at the, quote unquote, ‘professionals’, and I am literally making air quotes as I say that. And so, we, I learned from the people who were the, again, air quotes, ‘expert in the field’. And it took a while. So, it was a while. It was probably about 10 years that I was listening to those experts. And I met a dear friend who you will hear about in our training, her name is Judy Endow. And she’s an Autistic woman. And she was the one that really, I think, changed the course of my professional life and the course of my personal life, too. In just that I started to — she was the first one that I really, really started to listen to because she was my friend. And this sounds horrible when I hear myself saying this. And I also think it’s really important for everyone to hear this. Like, it’s so important to know growth is possible. And so, I worked with local autism societies and places like that with Judy. And we were really starting to prioritize highlighting the Autistic voice. And I’d like to say, you know, I got 10 years into my career, and then I started to listen to Autistic people. And Meg, that was the turning point, I would say, in where the direction I was going in and the direction I am now was that it was going to conferences that highlighted Autistic voices, and not the other ones. Like, making that conscious choice to like, this is what I need to do. There were some things that were happening even from the beginning that never felt okay to me, that never sat right. And so, it was it was that. It was that, just getting more exposure to Autistic adults, mostly, that were telling their stories and listening to them.
Meg:
Thank you for sharing that. I think that’s probably relatable to a lot of our listeners, and such a testament to how inclusion benefits us all, right. If we don’t have these relationships, it takes a lot of intentional effort to work on our perspective taking if we don’t have relationships with folks with different identities.
Sharon:
Absolutely. Absolutely.
Meg:
What about you, Lisa, what’s your story?
Lisa:
My story is somewhat similar to Sharon’s, actually, although I entered undergraduate school planning to go into business. And I spent my first year as a business major, and I needed to find a job for the summer because I needed to make some more money to help with tuition. And I had planned to do some work in a business office. But my mom, who was a special education teacher, she kept sending me this newspaper ad that was, you know, back when you had like, had to clip it out of the newspaper. And she kept sending me this ad that there was a family looking for an in-home therapist for their child, for their Autistic child. And it was an ABA program. So, I’m going to name that right away, too. But I kept telling my mom that I’m gonna be a business major, mom, like, stop sending this to me. But she kept sending it to me. And so, finally I was just like, okay, I’ll just, I’ll just go meet this family. And what’s true is that I had for a long time said that I wanted to be a teacher. But then I shifted that. And so, she was, I think, still, like connected to that idea and maybe seeing that in me. And I was like, all right, why not? I like kids. And so, I went to meet this family. And, like Sharon, I just kind of fell in love with this little girl. And so, I was like, this seems fun. And it seems more fun than maybe some of that filing and places that I was going to be doing. And so, I started to work with that with the family for just a couple of hours a week. And over the course of that summer, like, went from working just a couple hours a week to working like 20 hours, and really cutting back on that business piece. And so, that fall, when I went back to school, I changed my major to rehab psychology, and, you know, switched out of the business program, and found another provider in our area to work with.
And as Sharon named, we both got our kind of entry into the fields in ABA. And that was the only source of funding for families. And in many places, it still is a prime, the primary source of funding and families are kind of told that that’s their only option. But 20 years ago, that really was, like, this is what you do. I think that I felt lucky that the second provider I worked with used Greenspan and they were really looking to challenge that ABA is the only model to go with, but still having to work within sort of that funding framework in our state at the time. But I feel really lucky that I was able to then like learn about sensory pieces and more play-based pieces and approaches that follow the child’s lead more pretty early on. However, that doesn’t mean that those were sort of affirmative approaches in entirety, either. But I, as Sharon, like, I just felt this deep connection to the kids that I was working with. And so, I stayed in the field. As I said, I changed my major. I really never switched, like, the population I was working with. That became my focus. And I really felt like over time, we started to question all of these myths that, like, the pathological model was putting in front of us. So, the idea that we needed to teach people to make eye contact, for example, and that this is a really important part of treatment. You know, as Sharon said, like, there were certain things that just never felt great to me. And it felt really good when we started to see the reason why this isn’t feeling great is because it’s wrong. And so, let’s change that. And to be able to be part of that shift to change it was really important for me and for my career. There came a point I focused, you know, in the in-home programs, and then I ended up doing a lot of school consultation. And there came a point for me where I was also really just knowing then, noticing the mental health needs of, of the Autistic population. And so, I went back for my masters in rehab counseling, and specifically looked at how do we support mental health in Autistic people. And that’s kind of what brought me to where I am today.
Meg:
I love, love, love the role of your mom in the story.
Lisa:
I know. She’s gonna be so excited when she listens to that.
Meg:
This is incredible. As a mom, I’m just noting persistence here is the key element. That’s great. I came across your work — I don’t know if I even told you this because I sort of cold reached out to you maybe a year ago. I came across a talk on trauma informed care for Autistic people that y’all did. I noted the use of identity-first language in the title, which is usually just a signal that somebody has a practice of listening to Autistic people, especially if it’s non-Autistic presenters using identity-first language. And I watched your talk and throughout it, I was like, okay, like, these folks have a real practice of listening to, learning from Autistic people, and Autistic people with intersectional identities. And it was so refreshing. And the content that you all have been helping with at Learn Play Thrive is on trauma informed care. So, as we sort of dive into that content, I just want to get you to define it. What is trauma informed care? And why is this especially important for Autistic clients?
Sharon:
I think in kind of thinking about trauma informed care, Meg, what I really think about is just like having, coming into any new relationship with the understanding that what happens before matters to that person. And it is what happened before has an effect on the person they are bringing in front of you today. And that, to me is being trauma informed is just that, that every single human being that is walking the planet has this background. And I think your question about why is it so important for Autistic individuals, and I won’t even go further to say like anybody who comes from a group that’s considered in a position of having less influence and power in a community is that there is an automatic trauma in being part of one of those groups. And so, for me, like that intersection of understanding you are coming to me today, as a person with your whole — I can almost picture it, right, the whole everything that ever happened to you, behind you. And knowing that being part of this specific minority group just adds to that, and adds so many layers to it, is why this intersection, I think, makes so much sense to Lisa and I, and why we spent so much time working here. Because I think when I started learning more about trauma, I think — and Lisa can speak to this, too — I think I came to it kind of backwards from a lot of people. I think a lot of people come and enter into the world of trauma. And then, they realize like, oh, Autistic people may have trauma. For me, I already knew a lot about Autistic people when about 10 years ago, I started to learn about trauma. And I remember, Lisa and I had so many conversations about this where we were learning new things about trauma. And we’re like, well, this is Autistic people. And it was like, just some of the components of the sensory sensitivities, and the being hyper aware of your surroundings, and possibly, we talk about this in the training, but possibly having neurology that is more focused on possible threats. We’re learning this stuff about trauma, and we’re going, “But this is Autistic people,” like, this, this matches. And it was just it was fascinating how those two intersected. And then, learning more about both, we just really started to like understand why.
Lisa:
Yeah, absolutely. And I would add to that, that because of that we also, part of being trauma informed when you’re specifically talking about Autistic people or we could expand that to like the wider neurodivergent population, is that their trauma, there’s the past trauma, but then there’s present and ongoing trauma that is a result of living in a society that largely favors neuronormative expectations. And so, part of being trauma informed, then, a big part of it is building that awareness in ourselves. Because if we don’t do that, if we don’t build our awareness of those factors of the individuals, on cultural factors, and the historical factors that have impacted them especially from systems of power, then we really do risk retraumatizing clients, and we’re going to compromise in our ability to provide them a safe space to obtain their treatment or to obtain the support that they’re approaching us for.
Meg:
You know, it’s interesting. As an OT, I feel like we have almost the inverted experience that mental health providers might have that we’re often starting from things like developmental milestones and these discrete observable skills, and then eventually adding on how’s that person doing? What do they need to feel safe? How can they feel safe in order — I was gonna See how can they feel safe in order to learn, but I want to pivot and say how can they see feel safe in order to feel safe? Like, feeling safe just is a thing with really, really high value and importance in itself. And there aren’t a lot of good trauma informed care trainings that I’ve been able to find for providers like OT’s who are — we’re not necessarily trained to start there. And like you said, whether we’re looking at it or not, it’s happening. And it’s impacting our clients.
Sharon:
And Meg, to go off of what you said and Lisa said, the whole, like, ‘How do I make this person feel safe’, the importance of doing it for Autistic clients is they are coming to us already in a world that is not safe, right. So, then you already are, you have to make it almost like a little bubble of like safety around them when they are with you because the world is not by definition safe for them.
Meg:
I’m just sort of taking that in, that we want our time with our clients to be a little bubble of safety, which is really different from people thinking, “Oh, I need to, I need to push this person so I can see how they react, so I can problem solve it,” or I need to create all of these stressful circumstances. When y’all are saying let’s start with creating a space that creates a felt sense of safety for our clients, which isn’t intuitive, right. We are all familiar, I think all of our listeners are familiar by now with the double empathy problem. We know that we can’t intuitively imagine the perspective of our Autistic clients and what safety means. So, I want to ask you a little bit more about your journey of listening to Autistic people and having that shape how you view your practice, how you view trauma informed care. What has the impact of that been for y’all?
Lisa:
That’s such a big, like, question. It’s hard to — I feel like it’s hard to narrow it down a bit. But I think that there was this huge realization for me that so many of the things that we were being taught were false. And that if I continued to approach my work with those kind of pillars, like what was being upheld, as the correct way to go and the correct way to provide treatment and the correct way to think about things, that I was doing such a disservice to the human beings in front of me. And by shifting that and flipping that, we had to do that through deep listening and really challenging ourselves to step out of this paradigm that we were being. Like, that the funding source was like, funding sources, but it’s even bigger than that, right? It’s the educational paradigm. It’s the world view that we’re living into, to step out of that and step out of the pathology model. And to just listen to people and trust them that they are the experts on their own experience. That was so freeing as a provider. Like, I don’t have to be the expert, you’re the expert on your experience. And that, I mean, just that shift has made such a difference for me and how I approach my work in terms of trying to help people come in contact with themselves and with, like, and help them bring forth that expert within them, what’s in there, that’s inside.
Meg:
That’s lovely. Do you want to add anything to that, Sharon?
Sharon:
Yeah, I’d love to go off of that just a little bit. I think that, you know, for me, listening to Autistic adults, obviously, like I already said, they kind of then became the expert in my mind. And I think what really changed and challenged me to look at my own ableism and all of this was having not just like one person, but communities of people. And Meg, I just want to say like your podcast and the work you’re doing, I think, really helps to like build up communities. It feels very different when you just are learning from like one Autistic person, but when you have a whole community that is embracing all of these things, it really, really gives you space to challenge, to like challenge your own, what’s going on for yourself. And so, I just want to say, like, what really changed for me is I wanted that. Like, I wanted a community of people who were going to be like, “Sharon, when you said that, I think it was kind of ableist,” like I wanted that. Like, I welcome that. And it did. Honestly, it took me a while to get there. I’m so grateful for the community of people and the safe people I have, that I worked with, that are willing to do that with me and go on that journey with me. Because again, it’s about creating safety for all of us. And so, I want to be with safe people who are going to be able to say, “Hey, Sharon, what you just said there, can we can we say that differently? Can you think about how you said that?” Because I appreciate that because I am with people who want to learn and grow. Yeah.
Meg:
So, shout out to the people listening to the podcast episode. I mean, each episode gets 10s of thousands of downloads. And it matters. It matters to all of us here in this space together. And I think that’s a really nice reminder that listening to Autistic folks, or listening to the populations we serve and people with intersectional identities within that is a part of culturally responsive care. And that it’s a practice. Sharon, you just demonstrated that so well. It’s not like, “Do this, and this, and this, and you’re done,” it’s an ongoing practice with mistakes and feedback and change. When y’all made your trauma informed care course for Learn Play Thrive, we have a whole group of consultants who review everything. A lot of them are Autistic; we have folks from different fields. And it was it’s a really, really sweet process to witness people say, “Oh, what if we add this?” or, “Oh, actually, here’s my experience as an Autistic person, that slide didn’t resonate. Is there a way to make space for this other experience as well,” and watching the interactions between those of you creating the course content and all the consultants giving feedback is always a really, really lovely process of like, “Yes, thank you. Tell me more.”
Sharon:
Absolutely. Megan, one of the learning points for us in doing that process we just talked about which I think speaks to the growth that this community is having is, you know, this, the whole project is focused on the intersection of trauma and autism. And so, that’s where we were focused. And that’s where you’re giving a lot of energy. And some of the feedback we got was like, “I am an Autistic person, I don’t actually think I’ve experienced trauma in my life.” And Lisa and I are like, wait a minute, like, how can that happen? And then, we integrated that feedback. And we changed some things that we put into the training because that is really important and amazing that we had a person who’s like, “This is not, this has not been my story, this has not been true for me.” Amazing. And I need that feedback. And I actually want to hear that feedback more. So, it was great. And I love to be challenged in that way.
Lisa:
Yeah. And, you know, when I think about that whole journey of becoming trauma informed, of becoming neuroaffirming in your practice, it is a journey. And I think if you’re in the beginning of that journey, it can feel really vulnerable. Because as you listen to Autistic voices, as you listen to people, you are likely going to encounter some things that you would do differently that you wouldn’t do anymore. And being in that vulnerable space is that, is, to me, the start of the journey. And we’re at a different place with that now, where, you know, Sharon, you just named, like, yes, tell us, call, let us know, right. I want to hear it. Because we’re not going to arrive some day and be done learning about this. There’s not an end point. There’s not a checklist that we can say, “Oh, I did all these things. So, now I’m trauma informed,” or,” I’m neuroaffirmed.” Like, there’s principles, there’s things we incorporate, but it’s a journey that’s going to be lifelong. And I feel like for me when I, like, came to notice that and accept that, again, it just allowed me to approach this from a much more open place. You know, like there’s not this goal, there’s not this thing that I’m trying to achieve. It’s a journey and a path that I’m on now. And I’m, you know, lucky to have these people that are on this path with me. And we’re seeing more and more people getting, you know, coming into that journey and being on that path with us. And that’s really exciting.
Meg:
It really is. I want to pivot back a little bit to trauma informed practices. Like we’re talking about, it is a process and there’s some basic pillars that anchors us to trauma informed care. Can you talk a little bit about what is at the core of trauma informed practices and how to make sure those are as meaningful as possible for our neurodivergent clients?
Lisa:
Sure. So, I think we’ve talked some about being, you know, at the core is this emphasis on creating safety. So, safety and environment, like, when I think about that bubble Sharon was talking about, safety and environment, but also safety in the relationship. And then, meeting a client where they’re at, considering them as a whole person, including their past, their present, and then being aware of those cultural and historical factors that are impacting them. So, I think, like, that’s sort of, to me, like how we’re going to enter, right. But then some of those other pillars would be collaboration. So, you know, recognizing that as a clinician, whether you’re a clinician and educator, like, you are in a position of power and authority, and so really being intentional on how you’re going to work on, like, balancing that and evening things out so that you’re really collaborating with the client, versus like, oh, I have this kind of agenda, I have this approach that I really want to use. Choice. So, making sure that there’s a lot of space for that. What we’re doing, where are we going, what do you want to do? And I think, like, when I specifically think about choice and Autistic or other neurodivergent clients, at a very young age, they maybe have gotten the message that they need to suppress parts of themselves, suppress ways of being in order to get along and be in this world. And so, a lot of choices were taken away from them, even just the choice to be yourself. And so, like part of, for us, I think, in our work with Autistic clients, when we think about that pillar, for example, of choice is how do we work with a client and knowing like authentically, you have the opportunity for choice in this space when we are together. And recognizing that there’s probably a lot of time in their life where they don’t have choice. So, they might not even kind of, like, we’ve had clients come into our sessions, like, they are looking for us to make every decision because that is how it’s been for them. And so, I think when I think about like the specific, some of the specific things, it’s like taking that time to really be intentional about how we are building in that choice. How are we building in consistency, and clarity and expectations? These are some of the other pillars. And how are we doing that in a way that matches the person’s neurology?
Meg:
Hearing you talk about choice like that is so interesting, because I think often in — I’ll speak for my own field — in OT sessions, we can integrate choice sort of superficially. “Do you want red balloons or green balloons?” And when you talk about choice, you’re talking about creating an opportunity for the client to safely find their perhaps very, very quiet, internal voice.
Lisa:
Yes.
Meg:
And to feel safe to find that voice to listen to it and to act from that space in a way that they might not have been given permission to in their lives at all. That’s really, really different than the superficial add on of choice. I appreciate that. What would you add, Sharon?
Sharon:
I think the only other pillar that really comes into play when we’re talking about Autistic clients, specifically for us, is just the sensory pieces, Meg. I just need to say more about that. And I think we just knowing what we know about trauma, too, is we know that any pieces that we’re adding for our Autistic clients are just going to be beneficial for like all the clients we serve. So, I know we have a lot of different kinds of therapists on here. And I just think that’s really important to name, is like anything you’re doing to support like sensory, either it’s choice or either like limiting sensory insults, we work really hard to do that. And it is coming back to that, how do I make this safe, and just realizing how much that the sensory components can play into that can be really eye opening, I think. And again, Meg, across professions, like I don’t just want your OT to be focused on those possible sensory insults and possible sensory differences. I want the speech therapists to know that, I want the teacher to know that, I want the mental health professional to know that, I want that to be across the board. And so, that’s another one that specifically trauma informed for Autistic clients is really important.
Meg:
I think that’s a really interesting point because things do get so siloed and, you know, I’m here as an OT asking y’all to teach us, all different fields but I would say mainly it’s OT’s and SLP’s at Learn Play Thrive — increasingly social workers and school psychologists — asking y’all to help us understand how to best care for our client’s mental health, their internal experiences, their sense of safety, right, because we can’t just, quote unquote, ‘do OT’, ‘do speech therapy’ outside of that. And personally, I have a maybe different take on sensory processing than some people in my field. I can’t find a reason that sensory processing would exist more in the domain of OT’s than anyone else. It’s not an occupation in itself. It’s a, it’s a client factor and environmental factor that we consider in engaging an occupation. But it’s something that a speech language pathologist, a mental health provider, that anybody would need to consider. And often, it is OT’s who have a lot of training and can share that knowledge. But I love that you”re taking it out of this, “Oh, this is specialized and only OT’s can do it.” It’s like, no, this is important. And we all need to do it.
Sharon:
Especially speaking as a mental health therapist, like, I feel like all therapists should know about this. Like all therapists should know about sensory processing, they should know about the eight senses, they should know about interoception. And I think if you are you a trauma therapist, you need to know about this. And I do think all of these things have been in the field of trauma for a long time. I don’t think us as therapists have always done historically a great job integrating that information into practice.
Meg:
Y’all do a great job of it, and you teach on it in your trauma informed care course. And you do it in a really lovely way. And I just sat and kind of smiled. I was like, I’m an OT who has mental health practitioners teaching the one course that really focuses on sensory processing. And you do it so well. It’s funny that it landed that way. But I’m really, I’m really pleased with it. And I think there’s a lot of value in that skill sharing, information sharing, collaborating, so we can all create environments that really do feel safe for our clients. Can you give us some concrete examples of what it would look like to work with a client in a trauma informed way?
Sharon:
Absolutely, I can. Go ahead, Lisa.
Lisa:
I was just kind of thinking along the sensory realms. So, maybe I can start with some examples there. So, in our space, we have probably four different treatment rooms. And so, something that I might do first session with a client, one, is I, ahead of time whenever possible, we’re going to give them information about our environment. And what we’re going to do. So, the first time that they’re here, you know, there’s a waiting room, here’s what it’s like, you can feel free to stand, sit, walk, use fidgets. So, letting them know, like, in this space, here’s how you can be, you can, and I’m not going to direct how you can be but feel free to be in any, like, the way that you want to be. And then, we’ll give choice of treatment rooms, that’s another example. So, whenever we can, walking a client through the space and letting them choose what room is the most comfortable for them. And we’ve had clients say, like, “That room, you know, this room, the vent in that room is way louder than the vent in this room. So, if we could be in the other room, I’m gonna be able to be more present for sessions and less focused on that vent that’s making a sound that’s really bothering me.” And then, thinking about like, what are the other things in your environment, sensory wise, that we need to add, that we need to take away. And being flexible with it, I think, that’s what we’ve learned is really important, too, within terms of the environment, is what works for one person, what’s trauma informed for one person isn’t necessarily trauma informed for the next person. And so, having that flexibility of where you want to sit, how you want to sit, maybe you don’t want to sit, maybe we’re standing. The furniture arrangement, even. Like not having something close to the door. We have clients with, you know, have had experienced, like, locked rooms. And so, having the door closed, like, can the door be closed or does it need to be open. So, all of, like, those are just some examples of that thing around space, I guess, and creating that safety right off, right away, right from the beginning we try to do that.
Sharon:
I think the other thing that we do a lot like is just to make sure that we have our expectations laid out really clearly before we even start. And it’s something that I feel like for Autistic clients is especially important, some of whom who have had possibly traumatic experience in prior treatment, prior therapy. And so, really laying out like this is what, when you are with me, this is what it is going to look like. And here’s where you’re going to have choice. And this is where you’re not going to have a choice. This is like a hard end or a hard start. So, just laying out those expectations before we even begin, I think, is really important. Because then they kind of, they know, we all know what to expect more when we’re together. And also giving space there, too, like if some of what I’m saying doesn’t work for you, let’s talk about how to do it. I won’t — we all of us that it at our place we work won’t forget, like, Lisa did have a client who needed the door open. And that changed the way all of us interacted in the space during that time. And that was okay. That is what her client needed to feel safe. And so, you know, I think that’s the point of like it becomes bigger than just the interaction of the two of you, per se, during that time. It became bigger for like the whole system, and the whole system supporting the client in that space, in that interaction.
Meg:
Thank you so much for sharing.
Sharon:
And yeah, and I think, Meg, like that, even deeper goes into, I think, so much part of all of our work is not just the direct work you’re doing with your client or your student, but it is the work of, you know, we call it psycho education in our fields, where we’re educating the people surrounding the person about their needs, and about how to best support them. And I think so much of our work goes into that, too, Meg. It’s not about like, necessarily, again, I’m air quoting, ‘changing the person’ that’s coming to us. The majority of the work may be around changing the environment, or changing the people that surrounds that person.
Meg:
Yeah, I think some of these shifts are things that would be so easy for us to miss, too. Like Lisa, you mentioned the loud air vent, if we weren’t listening and making space to learn about that experience, we might never notice it. And Sharon, you mentioned the open door, I’ll tell you a personal anecdote. After I finished reviewing your course, I have a four-year-old, and my four-year-old was having a four-year-old meltdown. And I just took her out of the space we were in and calmly like went to her room with her to sort of coregulate in a more controlled environment. And she said, “It’s okay that you bring me here. But I wish you would just leave the door open. I will feel better if you open the door.” And I had your voices in my head and I opened her door and she said, “I’m gonna calm down now.” And I don’t know why I hadn’t heard that from her before. I hadn’t listened before. I hadn’t thought of it before. But it was something about learning this from y’all allowed me to sort of see her experience of being in here with the door closed doesn’t feel safe. So, it’s interesting how as we learn to be attuned to these things, we can really start to see the possibilities and the impact for our clients, things we might never otherwise think of. So, thank you from me and my four-year-old, who was in fact hungry. So, I want to ask you to tell us a little bit about your new course. At the time this episode comes out it should be open for pre-enrollment at a lower price than it will be once it fully launches. The course is called ‘Trauma Informed Therapy for Autistic People’. Behind closed doors, we’ve been calling it by its acronym TITAP. So, news to y’all, right. Tell us about TITAP, tell us the scoop.
Sharon:
The course that we recorded, we really got into just trauma informed basics. We kind of started there. And then, we got into some specific traumas that are very specific to Autistic people. And so, there are some. And that is really important to know, too, like when we have these people coming to us, what could be the specific traumas that are more likely to occur in the Autistic population. And so, we got into that. And then, we absolutely got into environments and practices of what we can do to — so, part of it, as we said before, Meg, is like knowing the trauma, the background, everything people are bringing to you. And then, the part Lisa talked about is not creating new. And so, we got into the environment and practices and how are we going to make these spaces as safe and as, hopefully, less traumatizing to our Autistic clients that are coming in.
Lisa:
And the course is designed for any professional who is working with Autistic clients. So, while Sharon and I are both mental health professionals, it applies to people in, you know, all sorts of education, you know, educators, OT’s, speech therapists, in all different professions. It will be useful for you, we hope so.
Meg:
I agree with that. I agree with that. I think it’s a course that has really concrete takeaways for anyone working with Autistic folks, and I’m so grateful that y’all are sharing this with the Learn Play Thrive community and everybody out there who’s wanting to learn and serve their Autistic clients in a more trauma informed way. Tell us what y’all are working on, where we can find you online.
Lisa:
Sure. Well, Sharon and I, we are working on finalizing a support model that we’ve been working on for a number of years that helps individuals to identify their, like, share, I guess, their traits and then look at supports that we can build in with them. Or, as Sharon mentioned, what psycho education needs to happen for providers or natural supports supporting that person. So, we’re really excited about that model. And that’s probably our next big project that we’re working to finish up. And then, you can find us on Facebook. Imagine Your Capacity, Counseling and Consulting. And you can find us on Instagram at Imagine Your Capacity, Counseling and Consulting, LLC.
Meg:
Thank you both so much. I am so excited about your course. I loved this conversation today. And I’m so grateful to both of you. So, thank you.
Lisa:
Thanks for having us, Meg. We’re really glad to be here and to be partnering with you all.
Sharon:
Thank you so much, Meg. Really appreciate it.
[Ending music]
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