Exploring the Possible Processes of Change During School Based Humanistic Counselling for an Autistic Adolescent
: A Theory Building Case Study

  • Jessica Gash

Student thesis: PsychD


Background: Autistic adolescents are more likely to experience interpersonal and psychological difficulties than their neurotypical counterparts considering distinct emotion processing difficulties. Emerging evidence demonstrates associated benefits of utilizing humanistic counselling approaches with this population. Underrepresentation in this area of literature warrants further investigation.
Aims: This study aimed to explore helpful processes of change for an autistic adolescent during a school based humanistic counselling (SBHC1 ) intervention, including examination of the client’s emotion processing. This study sought to build upon existing relevant theoretical contributions (McArthur et al., 2016; Robinson & Elliott, 2016), to inform the development of a humanistic model for working with this population. Method: This study utilized data from a randomized control trial which evaluated the effectiveness of SBHC (Cooper et al., 2021). The client was a 14-year-old autistic male (‘Harry’), seen in SBHC for 8 sessions. This research employed an initial thematic analysis and overarching, mixed-methods theory-building case study design to examine a rich case record.
Results: It was found that the counsellor’s focus on the client’s embodied experiencing, their transparency, use of process-guidance and the shared use of metaphorical imagery, were central in facilitating developments in the client’s emotion regulation, selfinsight, self-reflective processing, and self-agency across sessions. Prominent hindering factors included the client’s uncertainty surrounding client-counsellor power dynamics. The counsellor’s use of process- guidance appeared insufficient in supporting the client to develop other-insights and translate helpful skills externally.
Implications: These findings can contribute to psychotherapy practice by showing how specific counsellor interventions facilitate various helpful processes of change for an autistic adolescent during SBHC, whilst posing areas of theoretical consideration. This study is of a single case and has low testimonial validity. Thus, further research is required to understand helpful processes of change in SBHC in greater detail and breadth to account for the heterogeneity across this population.
Date of Award13 Jun 2023
Original languageEnglish
Awarding Institution
  • University of Roehampton
SupervisorMick Cooper (Director of Studies) & Jennifer Mayer (Co-Supervisor)


  • Humanistic
  • autism
  • counselling
  • therapy
  • adolescent

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