Autism & Mental Health, with Cheryl Checkers, LMHC, NCC | Spectrumly Speaking ep. 158
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IN THIS EPISODE:
In this episode, hosts Haley Moss and Dr. Lori Butts speak with Mental Health Counselor and ASD Specialist Cheryl Checkers, LMHC, NCC.
Cheryl is a Licensed Mental Health Counselor, National Board-Certified Counselor, and Certified Autism Spectrum Disorder Clinical Specialist who specializes in working with teens and adults on the autism spectrum and their loved ones. She is also a clinical consultant for FAU CARD, and thePresident of the Board of Directors of National Alliance on Mental Illness (NAMI) of Palm Beach County.
For more about Cheryl’s practice: https://www.cherylcheckers.com/
For more about NAMI PBC: https://namipbc.org/
For more about FAU CARD: https://www.fau.edu/education/centersandprograms/card/
Spectrumly Speaking is the podcast dedicated to women on the autism spectrum, produced by Different Brains®. Every other week, join our hosts Haley Moss (an autism self-advocate, attorney, artist, and author) and Dr. Lori Butts (a licensed clinical and forensic psychologist, and licensed attorney) as they discuss topics and news stories, share personal stories, and interview some of the most fascinating voices from the autism community.
For more about Haley, check out her website: haleymoss.net And look for her on Twitter: twitter.com/haleymossart For more about Dr. Butts, check out her website: cfiexperts.com
Have a question or story for us? E-mail us at SpectrumlySpeaking@gmail.com
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EPISODE TRANSCRIPTION: Note: the following transcription was automatically generated. Some imperfections may exist.
HALEY MOSS (HM): Hello, and welcome to Spectrumly Speaking. I’m Haley Moss, an author, artist attorney and I’m autistic. As usual Spectrumly is a two person co-hosted podcast and I am joined here by…
DR LORI BUTTS (LB): I am Dr. Lori Butts. I’m a psychologist and an attorney.
HM: How are you? I feel like there’s just a lot going on.
LB: Yeah, there’s always a lot going on it seems like right? It’s kind of very life is life-ing, right.
HM: Life is laughing is a very accurate description. So the last time we talked, I was almost getting ready to go on vacation, and I went on vacation and had an awesome time.
LB: Wow. How nice is that?
HM: It was very much needed.
LB: Good. Good. Did you get rejuvenated?
HM: I did. Except you know what happens when you come back from a vacation? You need a vacation from the vacation?
LB: Yeah, it’s it’s very punishing.
HM: I’m not used to taking a week off like when it’s not connected to holidays. So it was very strange to suddenly come back and be like, Oh, no, there’s a whirlwind of stuff I didn’t do.
LB: I know. It’s almost a punishment. It’s a punishment before to get everything off your desk before and then it’s punishment afterwards. Like, it’s stuff.
HM: I’m feeling that in my soul. Yeah. But I believe that the world needs more vacations and more men, little breaks and more ways to take care of ourselves.
LB: That’s for sure.
HM: But thankfully, we are talking a little bit about taking care of ourselves because as you may or may not know, we are here in the month of May, May is Mental Health Awareness Month. And to help kick us off. It’s really have some of these important discussions. We are welcoming Cheryl Checkers. Cheryl Checkers is a licensed mental health counselor, national board certified counselor, and certified autism disorder clinical specialist who specializes in working with teens and adults on the autism spectrum and their loved ones. Welcome to the show.
CHERYL CHECKERS (CC): Thank you so much, Haley. And thank you, Lori. Thank you for having me. I also wanted to mention Haley, I have one of your books that you wrote. With that you autograph for me. “Middle School: The Stuff Nobody Tells You About”. And I have had it on my bookshelf for many, many years.
HM: That is so cool.
LB: That’s really cool. That’s exciting.
HM: It makes me feel really cool. Like, oh, wow, I did a thing and people are excited about it. That’s so cool!
LB: It’s really cool.
HM: It means I kind of get to fan-girl in my own way. Like, wow, is there a chance I was a teenager when I autographed it for you too?
CC: You were. It was when kit first came out. So I’ve — as I’ll share you know, as we go through the interview, I’ve done a lot of work with heart centers over the years. And it was an event with NSU un card even before they were together, actually. They had us out at the Miami Dolphins stadium or something and you were there signing your book.
HM: I was a senior in high school. Wow. I was either junior or senior or so I must have been a senior is my guess because that was the year I did. One of those years was the year I also did the artwork for that. So I was in high school when we met then.
CC: Yeah, that is so cool. And I’ve watched you over the years through different brains and different things you’ve done and I’m definitely a big fan and and I share a lot of your material with with clients.
HM: This is warming my heart. But as much as I think this is extremely cool, and my heart is kind of fluttering around and it’s making me feel some type of way. We are here to talk about you and your work. So can you share with our audience how you came to specialize at the intersection of autism and mental health?
CC: Sure, my journey started actually more than 20 years ago as a parent of an autistic daughter who actually didn’t even have the diagnosis at the time. But that was a challenge even getting her a diagnosis. And it’s really what caused me to advocate and to to do so much in the field of autism and CO occurring mental health. back many years ago, the autism and mental health worlds were so siloed and you either had autism or had mental health it was such a challenge to get support for my daughter on either side. And to a large extent it’s thrilling still very difficult in my eye is have to find clinicians that mental health clinicians that understand the autism piece. So that’s what really brought me into the field, both as an advocate and as a mental health counselor that wanted to learn everything I could about autism so I could make a change.
LB: Can you tell us about some of the work you’re doing to make sure that the autism community has the mental health support that they need?
CC: Sure. I guess to answer that question, it would be really helpful to kind of talk a little about my journey after I shared with you as a parent kind of coming into this. So many years ago, I was a clinical support specialist for FAU card. And that was very early on so many co occurring mental health conditions couldn’t even be diagnosed back then if a person had an autism diagnosis. So while he advocated for mental health on the autism side, it was still pretty hard like most, you know, people that were on the autism side that had mental health conditions were sent, you know, were said, really, to the mental health clinicians, and if they thought they had mental health, or just kept on the autism side, if it was thought of as everything was through the results of the autism. So my journey then kind of took me to the mental health side of things, or I became a clinical director for the National Alliance on Mental Illness where I advocated again, but this time for the inclusion of autism on the mental health side. But again, it was kind of early on. And even though it was received quite well, the the mental health side didn’t really understand autism, so still kind of like referring to the other side.
So I continued my advocacy efforts and went into private practice and kind of fast forward. I always stay connected to CARD and to NAMI over the years, and I served on the constituency board of card and then I actually stepped down from their board to take on the role that I now serve for them, which is clinical consultant, where I lead a task force a professional task force of over 400 members throughout Florida, to cross train in autism and mental health. And so the goal is not only to bring a more understanding to mental health professionals, on what autism looks like, and what how mental health conditions can look different in autistic individuals, but also on the autism side to help educate on what mental health can look like and how mental health can appear sometimes that for instance, as maybe an autism struggle getting worse, or, you know, it doesn’t always look like very typical signs of mental health that we’re all aware of. So, kind of doing that cross training. So that that’s one initiative and then also I serve as president of NAMI PBC. And they are so receptive to including autism, in fact, you know, may being as you mentioned, at the beginning of the program being Mental Health Awareness Month, they’ve allowed me to have a speaker series on autism and cooccurring mental health. And it’s, you know, really increasing awareness that the two can coexist and what they how they can look different and you know, the importance of getting getting help for both the cooccurring mental health condition but also if there’s some autism struggles as well or just, you know, on that journey with many people that have a later diagnosis and kind of making sense of all of that.
And so I wanted Interesting fact I can share is, with the collaboration between Nami and card is a presented on autism and cooccurring mental health conditions with Dr. Jack Scott was the executive director of FAU card at the NAMI state conference two years ago. And that was the very first time a Nami state conference had included autism and cooccurring mental health. So that was a huge moment for me and I continue really I feel like we’re still in you know, the awareness stage, but I continue to advocate for change.
HM: That is awesome. And I’m very appreciative of the work that you do. So with that all in mind and this intersection all the work that you’re doing, what advice would you have For an autistic listener out here, that might want to find a therapist or a psychiatrist, or a counselor of some sort that understands their needs is an autistic person.
CC: And that’s a really good question. And there’s such a shortage of mental health clinicians that have that understanding of autism, but it’s so very important to find someone that does understand or is at least receptive to what autistic individuals needs are. And I do work a lot with women on that are getting like a later diagnosis. And oftentimes, they’ve been misdiagnosed with many other mental health conditions, and they’ve just like, treatment hasn’t worked. Or sometimes, unfortunately, they may end up with a psychiatric hospitalization. And like, there’s just always been a nice missing piece. So even advocating to get the diagnosis of autism diagnosis, if they believe that, that they have autism, and you know, just so many people, some, especially women, but a lot of the males that I work with, as well that that are later diagnosed, they have taken self assessments, and they they’re pretty certain that they do have it, but it’s really hard for them to get diagnosed. And then, you know, oftentimes that can lead to depression, or, like other mental health conditions can kind of be a as a result of like, Why aren’t treatments working? What you know, what is missing, I don’t really think I have these other diagnoses.
So I, you know, advocating for someone that understands both the mental health side and and their autism, especially late diagnosed, or someone that isn’t diagnosed yet, I think is so important, because then, you know, it’s that it’s such a life changer to have that diagnosis and, and have that understanding and be able to, you know, understand all the components like, you know, my masking, how much am I masking the, you know, am I do I have overload do I am I melting down and my you know, there’s just so many pieces that if they don’t have that diagnosis, and they don’t understand why these things are happening, they can lead to other other mental health conditions to kind of layer on so it is so important for both the diagnosis of autism and, and understanding the mental health conditions in that context.
LB: So on the flip side, how can the mental health professionals do better about meeting the autistic patients where they are and how has mental health professionals increase their skills?
CC: Well, I believe that, you know, having a better understanding of autism and also how mental health conditions can appear differently, having understanding of all these things, like meltdowns, and and, you know, overload and sensory and just having, like education, and I know, you know, at least I can speak for myself and I went to school many years ago, but, you know, I didn’t leave my graduate program with having that, that education on what, you know, autism looks like, even in higher art, like a later diagnosis, like most of what we learned, you know, talk about children with autism, and just even understanding like the female phenotype and how autism can look different in females, just so that, you know, mental health clinicians can have autism on their radar when they’re sitting across from especially their females in their office, because oftentimes, you know, it’s like we’re if you don’t have that understanding, you might be trying to fit into some category that might not be accurate, like, borderline personality disorder, for instance, is something I see females oftentimes misdiagnosed with when when it’s actually an autism diagnosis. And, you know, if it’s not on their radar, they’re not even thinking about it. And you know, that education is so helpful, just understanding like all these differences and and how, you know, and of course, you know, it’s difficult because oftentimes with females and males as well, with masking or internalizing, you don’t see overt behaviors or you don’t know how much someone’s hiding from you. So so I know it’s not You see, and it’s not to say that all mental health clinicians should know all of this, but, you know, in my advocacy in what I, you know, work towards so hardest to make sure that education is out there. So at least there’s the awareness that okay, you know, if something isn’t working in the clinical setting, could this be autism?
HM: You are giving us a lot to think about. So to help everyone out there, how can we follow what you’re doing? And if folks want to connect with you?
CC: Oh, well, one way is, if there’s, if there are any professionals out there that are interested in joining the FAU CARD ASD and Mental Health Task Force, you know, they’re welcome to join. We meet monthly and it is, you know, the goal to cross train our providers. So we have monthly speakers come out. And so it’s all about that education and also FAU CARD is in the process of trying to get grant funding to create a post graduate training for clinicians in autism. So they, they can become more familiar with the different profiles they might might see and clients in front of them and the different ways that mental health conditions can can look different as well. So we’re more they’re more able or you know, we’re all more able to pick up on when there’s a mental health condition that needs to be addressed. We do know 70% of individuals with autism have one mental health condition and 40% have two or more. We also know that you know suicide rates are six to 12 times higher and autistic individuals.
So I just feel like you know, it was so important that we do you know raise awareness and have this education so it is you know the the FAU CARD taskforce you can reach out to FAU CARD. We do also a lot of trainings through FAU CARD we have a female interagency task force where we have a we have different CARD centers, we have different psychologists and professionals from the community who specialize in female presentation of autism and we’re working really hard to put out trainings so that you know clinicians can watch these trainings, then they can gain a you know more information on what the female presentation can look like and how to support that best support females. So the FAU CARD YouTube channel has a lot of those. Also, you can contact FAU CARD and request a list of all the female focus trainings that we’ve done. I hope that answered your question. There’s a lot of ways to get involved. I guess the biggest thing is just being aware of the you know, the rates and understanding that, you know, anything we can do as clinicians is helpful because it helps us catch and and the mental health initiatives, but also like catch the autism if it’s being misdiagnosed as a mental health condition.
HM: I really appreciate all that. And to help our audience out as well, we want to transition a little bit to talk about some of the common roadblocks that autistic people in particular, may run into while seeking mental health care. And one of the biggest things that really shows up and you kind of touched on this a little bit earlier, is finding the right provider, because not nearly enough providers seem well versed in autism, especially when you’re an adult. And when you’re an adult, and you mentioned a lot about being female. And when you start adding different identities and marginalization it can be really hard to find someone that understands where you’re coming from has that knowledge base as a clinician, and makes you feel seen and supported and understood. I have always had it explained to me that finding a good mental health care provider is a lot like dating in the fact that you kind of have to find someone that you click with. And it’s not always the first person that you meet. So that being said, How can autistic people figure out what is a good vibe who is a good fit and who might be the right fit for them?
CC: That’s a really great question Hayley. And yes, like I liked that you compare it to dating because it is a relationship and you have to build trust and you have to feel comfortable and I one piece of advice I always give people is um therapists, like every therapist is not going to match with every client. So don’t give up on therapy, if you do meet with a therapist, and it doesn’t work for you, it could definitely be the bit. I, you know, the one of the first after that, like just keeping that in mind, like it could take a couple meetings with therapists until you find your right fit. But also making sure you do, you know, find someone that has experience and autism. So there are ways to make sure you know, you you’re reading bios, whether it’s on Psychology Today, or you’re calling your local card center to ask, you know, who do you recommend or refer to locally, you know, having starting with someone that has that knowledge and experience and could be very helpful, it doesn’t mean it has, you know, you have to find someone that has the experience, I know, people that have worked with therapists that weren’t specially autism specialists, and they still were able to help them but it certainly helps, you know, to find, at least to know what their background is, and, you know, the, the comfort level that they should feel in therapy is that they’re being listened to, because I really feel like whether it’s, you know, people on the on with autism are the experts, whether they’re female or male, like they’re the experts on themselves. And, you know, I think it’s really important to feel heard and accepted and understood and, and to be able to really have played an important role in your therapy and being able to set goals and, you know, even if it’s a therapist that might not understand all the, the components, like the masking and, you know, the autistic, the burnout, and all of those things, like they may not, not understand or have a lot of experience in that.
But if, if the person with autism is bringing that to the therapists, I feel like the you know, therapists will, you know, being open to learning about it, what does that mean for you, like, how we understand that and it’s just, it’s very important that therapists do view their clients as the experts in their, their autism and how it affects them so that they can, they can understand enough so that they can help in a way that that is, is really going to impact the person’s life. And oftentimes, with the later diagnoses, just going through life. Oftentimes, like a lot of the clients I work with, you know, they they feel just so invalidated and traumatize oftentimes, like these, you know, not being excluded or, or not being able to fit in or are feeling like you know, they’re not meeting the societal norm arms or you know, all these things it and just letting them feel heard, like this is hard, like going through, you know, life and not understanding why things are difficult. And, you know, and helping them feel validated for those challenges, but at the same time, providing hope and letting them know that they’re, you know, valued and appreciated and accepted for who they are and that you know, with autism cups, money, wonderful strengths, and when you find you know, what you’re good at and what you love, and you’re able to do it, you know, things change so much like it’s, it can be so life changing to be in and therapy with someone that that can help you realize your goals and what your want your life to look like and taking into consideration that the challenges along the way.
LB: That’s so true. And I also think I mean, which we didn’t touch on and not to be negative, but that it’s not only about you know, mental health professionals who don’t have adequate training, knowledge and experience, but also a shortage of just having mental health professionals just across the board that getting an appointment is even difficult for to get in to see someone and then it’s discouraging if you see someone and you don’t find that they’re the right fit and then you’ve got to try and wait on a waitlist again to find somebody else. So those you know, it can be really challenging to to face those kinds of roadblocks, especially when you feel Like, this is something you want to engage in, this is something you want to do to help yourself. So I just encourage our listeners to not get discouraged. That it could take, you know, it’s a process to get there. And unfortunately, you know, navigating that process is, is challenging.
CC: Absolutely Lori and especially since the pandemic, and, you know, the shortage of mental health counselors, as you said, and a lot of people isolating and, you know, kind of like doing, whether it was their school or their work or whatever they’re doing, it’s you know, virtual and then you know, having things like anxiety, you know, someone struggle with anxiety, having that kind of worsening, because you’re kind of keeping yourself away from the things that make you anxious. So you tend to maybe get, it’s harder to do the things that you used to be able to do. So. Yeah, there, it is important not to get discouraged and know that there is help and, you know, just it’s a process sometimes, and, but, you know, it is definitely worth it. So hang in there. And, you know, there, there are groups to like, sometimes there’s, you know, group counseling that if you can’t do something individually yet, and you’re waiting, you know, the another thing, you know, want to mention is through my work with NAMI. NAMI has, like the other services are free, they have support groups, they have social groups, they have all kinds of things on the mental health side, and oftentimes, they do end up with individuals that have autism and cooccurring mental health on that side of things. So just being aware that there are resources out there, and even if it’s that you’re waiting for a counselor, and and you feel like you need something more immediate, while you’re waiting there, there are resources out there, I think it’s very important to make sure we connect people with those resources.
LB: And that was a really great point about groups. That’s a really important piece that I brought and free groups and socialization and things like that, and, and meeting people that have that have gone through, you know, typically, if you know somebody who has a great therapist, or a great psychiatrist or something like that, that’s the best reference, right? Somebody that has is already a client and they can speak well. And you know, you’ve got something, somebody that you trust, and somebody in your social circle or in your family that points you in the right direction. But having that experience and, you know, joining groups are is also a great avenue to start that process as well. That’s that that’s a really great idea.
CC: Thank you, Lori. Yes, what you said about having, like having someone that’s already had success with something, whether it’s a program or a counselor or a group, or like, it’s always much easier, right? For any of us, if we know someone that, you know, we know has had success, or it was easy for them, or they liked the person or the person really helped them. You know, definitely, it’s a easier way to connect it. And, you know, the cart centers throughout Florida, you know, NAMIs are in all counties, practically throughout Florida too. So, you know, just have raising awareness to, like, there’s, there’s a lot of resources out there, and we can on the autism side, and the mental health health type, kind of, you know, have have even if we’re on the autism side, we can have those mental health resources so that we can share them when needed. And also on the mental health side, which is something you know, I see with NAMI and CARD because I closely connected with them, you know, there’s a lot of calls that come in through effing you card, whether it’s mental health and, and autism. And also on the NAMI side, there’s a lot of people calling, you know, what do we do? You know, my child or my adult child has autism and mental health, I don’t know, where do we turn, we can’t get help on the autism side or, you know, again, I hear that on the mental health side too. But there there are resources that that support both.
HM: And I think something we started touching on with referrals even is how important having family members or social connections and friends and folks to help refer Are you or help you on your mental health journey is really important. So I wanted to kind of touch on that before we eventually wrap up, because something that comes out a lot, or comes up a lot for that matter is knowing when to reach out and get help. That, you know, some of us just have things that happen in our lives that you know, there’s a random event that kind of affects our mental health, and then we kind of move on or we process it, and then it feels like you know, this might be something that’s a little bit bigger than just a grief, a job loss, something small, and that I really want to explore this, or I think I might be autistic, there’s a lot of things that come up, right. And sometimes having that push, perhaps from our family members, our friends, someone we work with someone we trust is huge. So how can we figure out when that right time might be to ask for help, especially if you’re like me, and you’re someone who is a reasonably independent person and a little bit stubborn and might not want to, per se reach out for help.
CC: That’s such a great question, Haley, and I’m not sure I can give it justice, but I’ll give it a shot. So I do, you know, work with a lot of adults who are, you know, not as receptive at first to come into counseling and might be their parents that are reaching out on their behalf. And I also see this a lot through Nami. So Nami has a lot of family support groups. And, you know, it’s when families see that their child or their adult child is experiencing something more than just like a disappointment, like it’s starting to become more and the or, you know, any kind of mental health challenge or struggle, I guess I’ll call it, that the parent becomes concerned first, and, you know, they’ll reach out and Nami kind of helps walk the family through, like, here, here are some things you can kind of, you know, like, you know, start to talk to your child about it is hard, like, oftentimes, like, for any of us, I think, when we feel like, you know, when we’re fiercely independent, and we feel like, okay, I have this thing going on, and I’m just gonna get through it, like, I have to be tough and, and I, you know, and it’s like, kind of, if I’m not, if I’m not tough enough, that means, you know, I’m weak or, like, whatever, you know, whatever we kind of bring with that when we’re, we’re facing our own challenges.
But I do think like, it can get to the point where it starts to affect our life, and it sometimes the soft approach of like, people around us that hey, I noticed you’re struggling, are you okay? Like, can can I be there done to listen, or sometimes it does start out that way. Like, just, you know, being there for for someone and I think that’s so important, because I think we all struggle at different times. And, you know, we, we tend to kind of push through and it’s, you know, there’s a saying, It’s okay, not to be okay, and Nami uses that a lot. And then sometimes we’re just not okay, and having those around us understand and be there for us. And it’s not always like, you know, hey, I think you could benefit from therapy as the first line of that defense with them. But it might be, hey, I noticed, you know, I noticed you’re struggling or I noticed, you’re, you know, you seem to have it be having a difficult time, can I be there, you know, Can I Can I listen? Is there something I can do and then, you know, just kind of working towards if you are able to do that if you’re a parent and you’re noticing some things with your child or your adult child, then, you know, just being there to listen, this is really a good first step in and trying to work kind of as a team. You know, sometimes I have oftentimes actually, when I have clients, my, my, my families might join with with their child at first because, you know, the child or adult child isn’t really quite, you know, fully receptive yet so we’re just kind of exploring and so I do think right now, like a lot of there’s there’s a lot of mental health challenges, challenges going out there and, and, you know, just being there for a co worker or child or parent, you know, our friend, whoever it is just to let them know we’re aware like the that they’re struggling and we’re here to hear them to listen to them is, I guess the best thing to start with.
HM: I think that’s a great message as well as just kind of listen and having that conversation be guided and knowing when to say when to. So it’s okay not to be okay. It’s okay to realize that mental health is part of your life and our lives as autistic people and for those around us to be more supportive. So I thank you, Cheryl, for all that you’re doing your advocacy and your efforts to make this world a little bit better for autistic people and their families. So again, if you want to fall, follow what Cheryl is doing and her amazing work, she does all sorts of cool stuff with FAU CARD and NAMI. I’m a big fan of what she’s up to. And I think that’s a great place to wrap up our conversation today. For the rest of us, be sure to check out differentbrains.org and check out their Twitter and Instagram @DiffBrains. And don’t forget to look for them on Facebook. If you’re looking for me yours. Truly, you can visit me at Haleymoss.com or say hello to me on Facebook, Instagram, Twitter, or whatever social media platform feels most accessible to you. And I’m excited to see what you have to say.
LB: I can be found at CFIexperts.com Please be sure to subscribe and rate us on Apple podcasts or your podcast app of choice and don’t hesitate to send questions to Spectrumlyspeaking@gmail.com. Let’s keep the conversation going.
Spectrumly Speaking is the podcast dedicated to women on the autism spectrum, produced by Different Brains®. Every other week, join our hosts Haley Moss (an autism self-advocate, attorney, artist, and author) and Dr. Lori Butts (a licensed clinical and forensic psychologist, and licensed attorney) as they discuss topics and news stories, share personal stories, and interview some of the most fascinating voices from the autism community.
