1. Daniela Tahirova, Milena Nenkova, Natalia Nikolova, Teodora Gerginova The Bernhard Achterberg Institute of Psychodrama, Individual and Group Psychotherapy (IPIGP) Sofia, Bulgaria Relationship’s Dynamics in Families with Children with Autistic Spectrum Disorder. Therapeutic ideas, Observations, Interventions

3. Exploring the relationship dynamics Therapist Couple Child with a problem

4. Our thoughts and challenges in the beginning…

6. Ivan Family 1 Anna 2y older Intention: to improve their relationship and explore deeper the cycles of conflicts that arise between them Therapy directions: clarification of the roles in the family - the mother, the father, the grandmother, the child. Models of behavior that work, and models that do not work. Rosi 72 Petar 69 Vladi 42 Oleg 40 Maria 60 Todor 62 Marti 12

7. Family 2 Ivelin 6 Adopted 2,5 y Ilia 40 Malina 45 Dani 62 Natalia 57 Vasil 64 Kostadin 62 Eva 60 Svetla 39 Intention: to improve their parenting together and the communication between them within the couple and with the child Therapy directions: to find more adequate view points on punishments, to rediscover support within the couple

8. Family 3 Ivan 56 Sofia Petia 53 Marga 40 Galia 30 Claudia 54 Serhio 56 Serhio 34 Marko 5 Mia Emilia 2 Antonio 4 Intention: to decrease conflicts and communicate more and easily Therapy directions: both partners to learn to name and express their emotions in an adequate way (both positive and negative) between them and in front of the kids; to identify differences and values ​​ in both cultures. Columbia

9. Questions How does the couple’s therapy affect the child with symptoms and how the meetings between the child and the therapeutic team affect the therapeutic hypotheses? Is the inclusion of the extended family in the child care an obstacle or a resource? Is it a positive or a negative for the couple to stay together in the name of being able to bring up a child with autistic spectrum disorder?

10. An idea applied to practice А member of our team to take care of the child and if possible, this to happen in the same place where we do the therapy session (in case that this does not disturb the process).

11. Observations The child as an active participant in the therapeutic space Child’s behavior visibly changes when there is a change in the communication between the parents. The awareness of the partners that the patterns in their relationship affect on the behavior of the child increases their involvement in the therapeutic process.

12. Features and Similarities In the therapy process we did not have any families in which the child is brought up by a single parent. Such people came to us, who have kept their family couple, no matter what is the psychological climate in it. The relationships in partner couples are in crisis, because: partners have different ways of accepting the diagnosis of the child and they also have different coping strategies; the way they support (or not support ) each other; the physical and emotional stress that the mother and the father experience.

13. Features and Similarities No space, time and resources left for the needs of the partners. Partners remain together as a couple, but actually one of the members is absent - physically and emotionally. In all the families we observed paradoxes in the relationship between the partners.

14. Conclusions The therapy sessions provide space in which partners can actively communicate. Working with an emphasize on the couple’s relationship is leading to improvement of the climate in the family system as a whole; it is giving the family new perspectives. When there are no resources in the larger system or in the child itself, we offer to find deeper resources in the couple. In families with diffuse borders, the willingness from the extended family to support and participate in child care can be an obstacle as it negatively affects the relationship within the couple and produces more tension.

15. Our thoughts and reflections after…

17. To be continued…

18. Thank you for your time and attention! Daniela Tahirova, Milena Nenkova, Natalia Nikolova, Teodora Gerginova The Bernhard Achterberg Institute of Psychodrama, Individual and Group Psychotherapy (IPIGP) Istanbul, Turkey 25.10.2013