Monday, December 19, 2011


Lisa Rowbottom is studying counsellors who intentionally modify their strategies to meet the psychological counselling needs of people who have FASD. It isn’t easy finding people to study, but she now has three, and is hoping to find a fourth. I spent an hour or so answering Lisa’s questions last Thursday morning. The benefit of that time went to me as well as to Lisa. She got a research participant, and I, preparing in advance to make good use of that hour, got the incentive to pull together my thoughts. In doing so, I noticed how counselling people with FASD is a process to which I haven’t given much dedicated thought. I’ve simply plunged in when the need arose, and felt my way in, paying heed to my knowledge about the complex set of emotional, cognitive and behavioural barriers I’d be likely to encounter, and the stories of real people that give me cause to hope that the effort is worthwhile.
I’ve lately been observing how, when it comes to growing up with FASD, things happen, but they happen slowly. A person who had never been able to communicate in writing will, in the early 20’s, suddenly start text messaging friends. A person whose grasp of math has never allowed for serious money management will, at the age of 29, take a score sheet and manually calculate the Yahtzee totals.
At conferences I often hear it said that people with FASD, showing remarkable verbal ability, appear to be smarter than they actually are. They talk a good line, but their actions don’t follow their words. The flip side of this is also true. People with FASD, in my experience, use their verbal ability to talk a good line sometimes, and a bad line at others. They ruminate. Their words influence their mental health in a very negative manner, and our words about how they never follow through compound the negativity, for us and for them.
FASD is a disability—a very complex disability—not simple, like blindness or deafness. If you fail to see it as a disability, if you try to break it down into parts and address them one at a time, you’ll get brain fatigue trying to understand it with logic, broken heart protecting yourself in its emotional storms, and a case of frustration so big that only an extended tropical vacation can cure it.
At conferences I have heard it said that insight-based psychotherapies don’t work well with people who have FASD. Frankly, I don’t think we know what works and doesn’t work. That’s one good reason, I’d say, for Lisa to be doing her study. Another good reason is that others, like me, have probably developed some undocumented strategies to use with people who have FASD. Undocumented is the operative concept here—explaining why we find so little useful counselling information in the literature. Alas, we counsellors have something in common with people who have FASD. We’ve been slow to develop.

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