Motivation and Purpose <p> With the increasing prevalence of autism spectrum disorders and higher education accessibility, it became crucial to address the adjustment issues of high-functioning individuals with autism spectrum disorders in inclusive college environments. This counseling practice study had three main objectives: (a) to understand the effects of expressive supportive therapy on alleviating anxiety and depressive symptoms in male college students with mild autism; (b) to enhance participants’ understanding of themselves and their interpersonal behavior patterns through the counseling process, thereby promoting a more flexible perspective on social interactions; and (C) to integrate the research findings and accumulate richer data on the inner psychological experiences of male college students with mild autism. <p> Method <p> This research adopted a case study approach, utilizing both quantitative and qualitative methods to collect, analyze, and explain the results related to the research questions. The study aimed to examine the changes in the participant’s interpersonal pattern during the counseling process through the mutual examination of quantitative and qualitative data. The research process included pre- and post-counseling assessments using the Beck Anxiety and Depression Inventories, 20 counseling sessions (each lasting approximately 50 minutes), and one feedback interview session lasting about 100 minutes. The first four counseling sessions constituted the assessment period, where a growth history was collected to facilitate conceptualization. The subsequent 16 counseling sessions constituted the primary counseling period. In this stage, the focus was on understanding the participant’s interpersonal wishes (W), responses of others (RO), and responses of self (RS) during interpersonal events (or relationship episodes). The data were analyzed and organized using Barber et al.’s (1998) Core Conflictual Relationship Theme (CCRT) classification. The 21st session involved obtaining participant feedback on the counseling process, which was then subjected to summarization, analysis, and synthesis. <p> Results <p> During the assessment period, the participant’s early interpersonal failures, due to the effects of the condition, had a significant impact. When facing challenges in a new environment, the participant experienced anxiety and uncertainty, feared others’ judgment and rejection, and felt frustrated by a sense of personal inadequacy. During the 16 primary counseling sessions, the participant’s wishes (W), perceptions of others’ responses (RO), and self-responses (RS) during interpersonal interactions displayed changes across three stages, according to BooK’s (1998) Core Conflictual Relationship Themes theory. While the primary expectation remained consistent across these stages, namely the desire to be “cared for and understood,” the responses from others were mostly characterized by “rejection or opposition,” leading the participant to feel “disappointment, depression,” and “helplessness.” Although negative responses still outnumbered positive ones, there were also some relatively more positive perceptions of others’ responses (RO) and self-responses (RS) showing improvement. Feedback from the interview revealed significant changes in the participant, including the restructuring of past interpersonal interaction patterns, learning to express personal feelings through actions, recognizing how previous negative experiences had affected their perception of information, and gaining a clearer understanding of the differences between themselves and others. The Beck Anxiety Inventory showed a reduction in anxiety levels from severe (28 points) before counseling to mild (10 points) after counseling. The Beck Depression Inventory showed a decrease in depression levels from mild (16 points) before counseling to within the normal range (9 points) after counseling. <p> Discussion & Recommendations <p> The results indicated a considerable reduction in emotional symptoms in the participant before and after counseling. This change in emotional symptoms could be correlated to the enhanced understanding of self and interpersonal patterns during counseling, which, in turn, influenced adaptation. For the participant, the primary counseling period had three stages, with the responses involving interpersonal wish (W), perceptions and responses of others (RO), and responses of self (RS) showing some variations but m aintaining a common theme of desiring to be “cared for and understood.” Nevertheless, responses from others largely entailed “rejection or opposition.” During the third stage, more adaptive responses of self that included “confidence and self-control” became part of the secondary response pattern. This indicated the impact of counseling on the participant, even though the enhancement of adaptive responses of self was slight. The feedback interview revealed that the participant learned to connect past experiences and current behavioral patterns, promoting understanding and insight. This represented a positive outcome of counseling. Finally, the study integrated the participant’s experiences throughout the counseling process and highlighted the impact of a medical diagnosis on personal growth. This impact extended beyond societal stigma and overall functioning, including the severity of symptoms, and included a significant aspect called “self-stigma.” The study explored self-stigma formation through aspects like “others’ recognition, acceptance, and interactive feedback,” “self-recognition and acceptance of the condition,” and “perception and internalization of interactive feedback.” According to the participant’s experience, although parents had a considerable understanding of the condition, their understanding was mostly used to explain behavior. Without proper application, this understanding offered limited help to personal development and might even reinforce stereotypes and prejudices against the individual. Additionally, early negative feedback from others continuously reinforced the presence of the symptoms, causing distress to the patient. However, even though the individual might have been unwilling to accept this reality, it did not change the fact of the illness. As a result, the condition gradually became accepted as part of the individual’s self-concept. This study suggested that counseling or consultation for people with mild autism not only assisted through learning approaches such as behavioral modeling. Another way to help them was by helping them understand themselves (e.g., interpersonal interaction pattern). It was hoped that a deeper self-understanding would help them integrate into society more effectively. While this research held practical exploratory value, its limitations lay in the single-case design. It was advisable for future research to accumulate more data, involving a larger number of participants for broader applications. In practical terms, interdisciplinary collaboration was recommended to offer more comprehensive assistance to individuals. Additionally, it was suggested that counseling and psychotherapy should not be limited by diagnostic boundaries, but instead, focus on individual needs. Based on the participant’s experiences, it was crucial to provide individualized needs during educational and counseling efforts for individuals with the condition and their families.
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