Examining the Relationship between Autistic People's Self-Esteem and Perceived Bias in their Alliance with their Mental Health Practitioner

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Abstract

After decades of suppression, the growing emergence of the social model of disability and the neurodiversity movement (Silberman, 2015) has illuminated autistic people’s perspectives on the mental health treatment they receive and the effects it has on them. This study explored autistic adults’ perceptions of anti-autistic bias from their mental health practitioners and the effect it had on their self-esteem. Previous research has indicated negative experiences with mental health care among this population and low levels of self-esteem; this study seeks to examine the relationship between those two factors and how positive therapeutic alliances can not only impact therapeutic effectiveness but also overall self-esteem for autistic people. A thematic analysis of qualitative interviews with 14 autistic adults yielded five themes relating to ways in which bias is perceived in the therapeutic alliance and the mental health field in general, and the impact it had on the participants. This study produces myriad implications for clinical practice and a deeper understanding of autistic people’s journey through mental health care.

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