Day 31 of 99 Days to FASDay: FASD and Therapy

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Welcome to Day 31 of our 99-day journey to September 9, FASDay.  Today starts a series of FASD myths and facts.

Our own experience agrees with the above. We went to many different therapists over the years. Many didn’t understand the brain difference and thus therapy failed.

The maiden had a fabulous doctor at one stage – she was also a psychologist and specialized in FASD. Unfortunately, she moved across the country and no one took over her practice. Seven years later we are still waiting for a specialist who can help guide her and monitor her medications – because I do believe her meds need adjusting.

In the end, I just try to read and learn as much as I can and help as I can while trying to access services.

Great Comment from Jodee Kulp (Red Shoes Rock):

We have seen neurodevelopment plus nutritional interventions work repeatedly to sooth and connect new pathways, however you are right the brain is cellularly different so to use strategies that work for TBI/Stroke are not fair to the person – to expect nuerotypical is not fair – but to embrace nuerodiversity in love – fun – play and learning we have been astounded. – Jodee Kulp

2018 Update: I am not a medical professional and cannot provide any advice. Always speak to a licensed and respected health care professional.

I found Addressing FASD in Treatment on the website for The National Center for Biotechnology Information. It is an excellent and thorough publication I would encourage you to read and suggest professionals you work with read as it includes a wealth of information on Fetal Alcohol Spectrum Disorder as well as tips on modifying treatment plans specific to a person with FASD.

Excerpts from the publication re. Therapy and Interventions:

Although the evidence base for effective substance abuse/mental health interventions with individuals who have or may have FASD is limited (Premji, Benzies, Serrett, & Hayden, 2006; Paley & O’Connor, 2009), research has demonstrated that this population can and does succeed in treatment when approaches are properly modified, and that these modifications can lead to improved caregiving attitudes and reduced stress on family/caregivers as well as providers (Bertrand, 2009).

Section 4: Tailoring Treatment for Individuals with FASD

This section will discuss appropriate approaches to modifying treatment and/or making necessary accommodations for clients who exhibit indicators suggesting FASD, or who show cognitive and behavioral barriers to treatment success, as identified in Steps 1 and 2 of this chapter.

This discussion is divided into two sections:

  1. general principles for working with individuals who have or may have FASD (regardless of age), and
  2. specific considerations for adolescents who have or may have FASD.

The chapter then moves on to Step 5, Working With the Family, and Step 6, Transition and Connection to Community Supports.

The section on Counseling Strategies breaks down each of the following suggested strategies: 

Due to the cognitive, social, and emotional deficits seen in FASD, counseling clients with these conditions requires adaptability and flexibility. Research data, clinical observation, and caregiver reports all suggest that it is crucial to tailor treatment approaches. Traditional approaches may not prove optimally effective, and more effort may be needed to convey basic concepts and promote a positive therapeutic relationship and environment.

The following were recommendations designed to help providers:

  • Set appropriate boundaries;
  • Be aware of the client’s strengths;
  • Understand the impact of any abuse the client has experienced;
  • Help the client cope with loss;
  • Address any negative self-perception associated with an FASD;
  • Focus on self-esteem and personal issues;
  • Address resistance, denial, and acceptance;
  • Weigh individual vs. group counseling;
  • Consider a mentor approach; and
  • Assess comprehension on an ongoing basis.

Medication as Treatment

Although not therapy-related, medications are a reality for some. I was at a workshop recently and a keynote speaker, Dr. Susan Rich, was speaking about medication and how many medications prescribed for people with FASD do not work as they do for the mainstream.

The maiden did see a psychiatrist, who adjusted her medications, but I am not sure she truly understood FASD. We also took an adapted Dialectical Behaviour Therapy (DBT) course in 2019 and while there were some skills learned, it needed to be longer and incorporate one on one sessions.

An article called Beyond Diagnosis: Interventions for Individuals Living with Fetal Alcohol Spectrum Disorder. St. Michael’s Hospital, Toronto. September 2005 (Link no longer valid) noted this about psychotropic medications and FASD:

There is a problem in discussing Psychotropic Medications and FASD because there is only one published prospective study on the subject, as far as I know. It relates to psychostimulants and ADHD in FASD children. All other references are retrospective and anecdotal. This is not surprising since FASD is not included in the Diagnostic and Statistical Manual of Mental Disorders and so is rarely considered by physicians who prescribe psychotropic medications.

If you are interested in reading more about medications and Fetal Alcohol Spectrum Disorder, there is some research and new developments in this area that will be featured on an upcoming Day in this journey.

Check back tomorrow for Day 32!

 

 

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