Autism spectrum disorder (ASD) is a neurodevelopmental condition that affects the way in which the brain develops and processes information, impacting the person’s communication, understanding of language and social interactions, and sensory use and interests (Monteiro, 2016, 2025). The World Health Organization estimates that ASD affects approximately 1 in 127 people globally (World Health Organization, 2025). A comprehensive systematic review and meta-analysis reported a global autism prevalence of 0.6% (95% Confidence Intervale, CI: 0.4–1%) and 0.4% (95% CI: 0.1–1%) in Europe, based on studies of individuals under 25 years old (Salari et al., 2022). In addition, a systematic literature review by Bougeard et al. (2021) reported autism prevalence rates ranging from 0.38% to 1.55% in Europe. In Portugal’s Centro region, Rasga et al. (2023) estimated an autism prevalence of 0.5% (95% CI: 0.3–0.7%) among school children aged between 7 and 9 years. Overall, epidemiological studies show evidence of a global increase in prevalence of autism spectrum disorder over the past years (Bougeard et al., 2021; Rasga et al., 2023; Salari et al., 2022; Talantseva et al., 2023).

According to the Diagnostic and Statistical Manual of Mental Disorders, (5th Edition, DSM-5-TR), the ASD is four times more common in males than females (American Psychiatric Association, 2022). Also, gender differences in the presentation of clinical symptoms can delay autism diagnosis or lead to misdiagnosis (e.g., females show fewer unusual behaviors, different repetitive and stereotyped activities and perform better in social communications than males) (Salari et al., 2022). The heterogeneity of autism profiles and presence of comorbidities with other neurodevelopmental disorders (e.g., intellectual developmental disorder, attention deficit hyperactivity disorder), psychiatric disorders (e.g., depression, anxiety) and/or somatic disorders (e.g., epilepsy, gastrointestinal disorders, sight/hearing impairments) can either exacerbate or mitigate typical autistic characteristics (Bougeard et al., 2021; Mckenzie & Dallos, 2017; Talantseva et al., 2023). Besides, a diverse range of multifactorial aspects (e.g., heritability, epigenetic mechanisms, environmental exposure, etc.) have been associated with the complex etiology of autism, contributing to the prognosis architecture of the ASD (Rasga et al., 2023).

Autistic characteristics and behaviors have a large impact throughout the individual’s lifespan (e.g., relationships), family functioning (e.g., higher family conflict), and society (e.g., high costs for mental health services; work absences) (Cridland et al., 2014; Houser et al., 2014; Karst & van Hecke, 2012). Consequently, this lifelong disorder imposes an extremely high economic burden on society and patients’ families (Salari et al., 2022; Talantseva et al., 2023).

Research shows that ASD is linked to high levels of anxiety, stress, and isolation in patients’ families (Salari et al., 2022). These families deal with higher stress levels (Houser et al., 2014; J. S. Romney & Jones, 2020; Solomon & Chung, 2012) including siblings (Spain et al., 2017), and more than 50% of parents and 70% of individuals with autism experience mental health problems (Brockman et al., 2016; McKenzie et al., 2019). Additionally, parents’ divorce risk persists even after their autistic children reach early adulthood (Karst & van Hecke, 2012; Solomon & Chung, 2012; Wagner et al., 2014). During developmental transition periods, individuals with autism may develop comorbidities (Cashin, 2008; Cridland et al., 2014; Helps, 2016; Spain et al., 2017), which creates even greater challenges for families.

Psychotherapeutic interventions for individuals with autism and their parents usually focus on individualized behavioral therapies and parent skills training approaches, respectively. These evidence-based psychosocial interventions have a positive effect on overall well-being (World Health Organization and the United Nations Children’s Fund, 2023). Nonetheless, previous studies on the impact of this disorder have been focused on individualized therapies and the behavioral outcomes of individuals with autism, and a proper evaluation of family factors is lacking (Cridland et al., 2014; Spain et al., 2017). Family factors can impact immediate and long-term effects of therapy (e.g., parental stress can decrease or eliminate positive outcomes from child interventions) (Karst & van Hecke, 2012; Romney et al., 2020). Thus, there is evidence of a transactional and bidirectional relationship between the individuals’ autistic characteristics, parents, and family distress (Da Paz & Wallander, 2017; Dallos et al., 2019; Karst & van Hecke, 2012; McKenzie et al., 2021; Spain et al., 2017).

There is a need to develop evidence-based, family-centered interventions to support the developmental needs of children, adolescents, and young adults with autism spectrum disorder (Helps, 2016). Additionally, therapeutic work should identify and enhance protective factors in families and individuals to prevent further development of mental health problems. Systemic family therapy is effective in relieving both individual and relationship distress (Helps, 2016). From a range of family therapy approaches there is a consensus that the narrative approach is the most promising model for working with families and members on the autism (Helps, 2016; McKenzie et al., 2019; Monteiro, 2016, 2021, 2025; Parker et al., 2020).

Narrative therapy has historically been effective for a wide range of clients, including those with challenging mental health conditions such as childhood conduct disorders, anorexia nervosa, and schizophrenia, which are often considered difficult to treat in mainstream mental health settings (Carr, 1998). Narrative therapists see individuals as authors of their lives, giving meaning to their lived experiences and relationships through stories that are socially constructed through discourse (Combs & Freedman, 2012). These narratives shape relationships and play a key role in both the development and maintenance of problems (Combs & Freedman, 2012). Thus, narrative therapists adopt a collaborative stance to facilitate the co-construction, telling, and retelling of stories that promote the reshaping of personal stories that reflect the clients’ preferred experiences and intentions (Carr, 1998; Combs & Freedman, 2012, 2016; Sequeira, 2021). By exploring alternative stories and perspectives, therapists help clients transform their relationships with problems, fostering new solutions and changes (Combs & Freedman, 2012). This process involves remembering and incorporating significant experiences, externalizing the problem, investigating and highlighting unique outcomes, thickening the new narrative, linking it to the past and future, documenting progress, and inviting significant family members to participate (Carr, 1998).

According to Michael White, applying psychiatric diagnoses to clients risks defining them exclusively by these labels, constraining their identity (Carr, 1998). Narrative family therapists see identity as a relational construct shaped by historically and culturally situated interactions and evolving over time (Combs & Freedman, 2016). Thus, identity is actively co-constructed through ongoing relationships across diverse contexts, reflecting on who the individuals are becoming through the stories they tell and share (Combs & Freedman, 2012, 2016). Therefore, it is during therapeutic conversations that narrative family therapists enable clients to reauthor personal narratives, reshaping their lives, problems, and identities (Carr, 1998).

This paper’s goal is to provide professionals working with families with autism spectrum brain style members with a brief systematic approach to narrative family therapy on the autism spectrum. This model was developed from the conceptual bases of Narrative Family Therapy (e.g., Carr, 1998; Combs & Freedman, 2012, 2016; Sequeira, 2021; White, 2007), narrative therapy developed with autism families (Monteiro, 2016, 2021, 2025) and evidence supporting brief family approaches (de Shazer, 1982; Shazer, 1985; Weakland et al., 1974). Accordingly, this paper systematizes Monteiro’s work and introduces the innovative contribution of a practice-informed structured brief therapeutic protocol.

The therapeutic intervention is specifically tailored to the individualized needs of families with members with ASD. This included the routine use of sensory-based materials and the introduction of the individual’s areas of preferred interest during the therapeutic conversation to facilitate the participation and dynamic inclusion of the autistic family member in the conversational therapeutic process. The use of the sensory materials and/or preferred topics of interest is referred to as the sensory entry point, as the clinician invites the autistic individual to share their worldview in a focused way (Monteiro, 2016, 2025). This, in turn, allows the clinician to structure the therapeutic conversation around re-storying autistic routines and interests as patterns of strengths and differences to help regulate the individual. The therapeutic conversation with the family shifts from diagnostic labelling to describing and appreciating distinctive brain style strengths and differences across family members, introducing a strength-based narrative as the entry point for transformation. The clinician guides the conversation using visual presentations of information, modelling the need for contextualization of verbal information to engage the autistic brain style (Cashin, 2008; Monteiro, 2016, 2025). A neuro-affirming stance was adopted by shifting from a disorder‑based perspective to a brain‑style framework, using the term “autism spectrum brain style” and “differences in brain style” as coined by Monteiro (2016, 2025). Introducing the narrative about the autistic individual having a unique neurodiverse perspective leads to the development of effective coping tools, strategies and strengths that support autonomy and emotional resilience (recognition and management of emotions) for the autistic individual and family members. In this therapeutic approach, the story begins with the deficit-focused narrative about autism that the family brings into intervention and holds a central place in their family life. The introduction of the sensory entry point leads to a shift in perspectives, and space is created to enlarge family stories to focus on positive connections and strength-based solutions. The clinician guides the shift from a family sense of powerlessness towards a sense of competency and capability. Therapy becomes a place where a normalizing and equalizing conversation can occur and the fundamental nature of the story changes.

Systematic brief narrative family therapy for individuals with the autism spectrum brain style

Therapeutic Context

Therapeutic conversations conducted in a sensory-adapted environment tailored to the sensory and communication needs of autistic children, adolescents, and young adults lay the groundwork for productive participation by all family members (Monteiro, 2016, 2025). The context where the therapeutic conversations take place is crucial in this approach.

The therapeutic setting should include a whiteboard and/or paper and pencil, and a set of sensory-based manipulative materials and/or related materials of interest, specific for each individual with autism spectrum brain style (Monteiro, 2016, 2025). By using the whiteboard and/or paper and pencil, we take advantage of their visual perceptual ability (a strength for many individuals with an autistic brain style). For individuals with autism spectrum brain style, being able to read the non-verbal communication, listen and integrating verbal communication can be hard work leading to a sense of feeling overwhelmed and withdrawing from the interaction (Monteiro, 2016, 2025).

Additionally, the presence of sensory-based materials serves as a sensory entry point to initiate and maintain interactions and conversations with the neurodivergent family member (Monteiro, 2016, 2025). The availability of these materials has two main goals: (1) to help the autistic individual organize their language so that they can express themselves in the conversation and (2) to allow them to use the objects and move away from the conversation so that they can stay regulated and take a break from interactive participation (Monteiro, 2016, 2025).

This brief systematic approach to family therapy provides clinicians with the necessary tools to observe and adjust their communication style to align with the autistic family member’s style, promoting engagement during therapeutic conversations.

Treatment Planning

This brief systematic narrative family therapy model consists of eight sessions over 5 months, with the first four held weekly and the remaining four held monthly, and a follow-up session three months after the last family session. Each session takes place over an hour and a half. The defined timeline aligns with principles of brief family therapy and accommodates the need for more intensive work at the beginning of the intervention. Early intensive sessions support the development of the therapeutic alliance and enable the clinician to observe initial indicators of change (e.g., increased reflexive abilities and shifts in family dynamics between sessions).

The therapeutic sessions are conducted by one therapist. The structured framework of this brief systematic narrative for families with children, adolescents, or young adults exhibiting a pattern of autism spectrum brain style was designed to help clinicians skillfully navigate through therapeutic conversations with families that are adapted to the individual and families concerns during therapy. Modifications to the number and temporal interval of sessions can be considered to adjust to family circumstances and needs (e.g., expanding the weekly sessions to biweekly and/or from monthly to two months).

Sessions and Processes

All sessions follow a specific structure. The therapist starts the family meeting with an invitation for the individual with autism spectrum brain style to explore their sensory entry point and/or address their topics of preferred interest (Monteiro, 2016, 2025). This first step is crucial. When the therapist aligns with the individual in this way, it communicates that the therapist understands his unique worldview and is creating a setting in which the autistic family member is valued, respected and heard (Monteiro, 2016). This initial step also provides family members with the opportunity to experience the autistic individual within a new situation, which will allow new perspectives.

Specific clinical skills are involved in this process, including mirroring the individual’s communication style, pacing the delivery of information to fit the individual, and sharing the exploration of sensory-based manipulatives and topics of preferred interest (Monteiro, 2016, 2025). Examples of these clinical skills are illustrated through a range of practices from brief in session adaptations (e.g., modulating vocal tone and aligning body posture with the autistic individual’s communication style) to more extensive therapist preparation across different stages of the therapeutic process.

The Albert case illustrates how incorporating preferred interests can foster connection, strengthen the therapeutic alliance, and promote the autistic family member’s active participation across sessions. In the second session, Albert (9 years old, male) attended with his blended family: his mother (46 years old), father (38 years old), and younger sister (7 years old). To support his engagement, the therapist introduced a set of prepared cards depicting sea creatures, one of Albert’s preferred topics of interest. Each card paired an image of a sea animal with a single descriptive word (e.g., “curious,” “protective”), which the therapist invited the family to attribute to different family members. This visually engaging and personalized strategy provided an accessible entry point for Albert’s active participation in the therapeutic conversation and aligned with his brain style differences. As this alliance is established from the beginning of the process, the need to start each session with the individual tends to decrease as the therapy progresses.

Narrative family therapeutic conversations provide the opportunity to support families in exploring four narratives shifts: Powerless to Capable; Dysregulated to Controlled; Prompt-Dependence to Autonomy; and Disorder to Brain Style (Monteiro, 2016, 2025).

During the therapy sessions, the shift from Disorder to Brain Style begins when the therapist explores the form and function of the individual’s behaviors and how this reflects the individual’s autistic brain style pattern of strengths and differences. Then, the therapist attuned stance allows the clinician to identify the form of the person’s behavioral patterns, preferred interests, and activities, and to link this form to its function within the individual’s lived experience. Consequently, the therapist becomes able to guide both the family and the individual in reflecting on solutions and strategies.

Albert was a visual thinker with a low threshold for verbal and social input in the beginning of the therapeutic process. This was evident in the first session, when he relied on his preferred routine by drawing the solar system on the board with the function of managing the verbal and social demands. In the second session, he engaged readily with the visual materials brought by the therapist, as previously described. In the third session, he drew the alphabet using dinosaurs, one of his preferred topics. After this session, he spontaneously developed a routine of crawling under the chairs and tables in the room, stating: “I’m going to the forest of chairs and tables!” as a way of communicating his need for a break from social and verbal demands. As this occurs, the therapist can share Albert’s story by reframing and describing the form and function of these behaviors, bringing his unique lived experience into the therapeutic space and creating room for reflection on the development of strategies and solutions that extend beyond the therapy room. A clear example of this process emerged in the follow‑up session, when Albert’s family described a strategy that had emerged naturally within the system.

During an intense work period for Albert’s father, he began creating and sharing short videos of himself with a toy from his workplace to maintain connection with his children and to support Albert through the behavioral changes he was experiencing during the Christmas school break. This solution reflected an adaptation that considered Albert’s unique brain style and created a meaningful bridge for communication and regulation. At the same time, the father’s initiative supported his wife, who was managing the children at home, while also offering the children an accessible and engaging way to navigate this challenging period.

Therefore, when the clinician understands the form of the autistic individual’s behaviors and associated them with specific brain style and sensory processing patterns, they can more accurately interpret their function and share it with the family. These functions may involve: (1) the need to establish and maintain predictable routines that support a sense of organization and regulation; (2) the need to engage in self-directed routines to buffer against overwhelming demands, such as managing language, social interaction, or sensory input; and (3) the difficulty of shifting from one’s own preferred agenda to accommodate the agenda of another person (Monteiro, 2025). Then, the deficit-focused narrative is decentered in three distinct and complementary ways (Monteiro, 2016, 2025).

The first shift away from the deficit-focused narrative involves the therapist’s intentional use of language and behavior. The therapist is a role model for family members about ways of interacting with the autistic individual, promoting effective communication and connection. This intentional process promotes a shift in the family regarding the way in which communication, interactions, and sensory needs and preferences are understood and incorporated into the family story (Monteiro, 2016, 2025).

The second shift toward an affirming autism narrative occurs when the therapist structures the therapeutic conversation to reframe and introduce new perspectives about behaviors through the lens of the person with autism. When the narrative shifts to a discussion of efficient ways to communicate and accepting differing brain styles, family members shift from feeling powerless to capable, as they better understand and appreciate differing perspectives and experiences, including those of individuals with autism spectrum brain style. This shift in perspective makes room for changes in communication patterns, leading to a sense of more competence in navigating communication and sensory differences. This deliberate process also opens a space to understand autism, making sense of the individual’s brain style in new and more adaptative ways. Changing the family’s conceptualization of autism provides an important alternative narrative for all family members. Everyone has a brain style characterized by areas of strength and differences. The exploration of this theme during the therapeutic process provides an opportunity to share differing experiences and perspectives in an inclusive way. Overall, throughout the process, the therapist comments, reframes, shares hypotheses and asks for clarification and/or confirmation while using strengths-based neuro-affirming language to help the family better understand the individual’s autistic brain style and lived experience (Monteiro, 2016, 2025).

The third shift away from the deficit-based autism narrative enables the family’s ability to move from dysregulated to controlled. Families collectively experience high levels of stress and distress when the autistic individual’s dysregulated brain is triggered in response to daily input and demands. Regulation strategies are introduced by intentionally understanding the autistic sensory brain style. Family members move from the destabilizing work of managing reactive dysregulation episodes to the steadier practice of supporting brain-reset regulation routines (Monteiro, 2016, 2025).

Prioritizing needs perceived as critical for their child/adolescent/young adult’s development, a parent may unintentionally foster prompt-dependency and consequently hinder the development of the individual’s autonomy and agency. The presence of a deficit-focused narrative that restricts and limits the vision about the autistic individual frequently leads one of the parents to over function. In other words, the parent puts themselves in a very active position, but they feel completely powerless and ineffective. The theme of over functioning is introduced in this model using the narrative language of inviting the parent to explore the following question: Who is working harder to make this change happen?

In this systemic narrative therapy model, the therapist advances the understanding of the autistic family member’s executive functioning brain style differences and how those differences affect initiation, organization and follow through with daily tasks. The therapist purposefully introduces and models the use of visual contextualization supports in the form of checklists, T-charts and other visually organizing tools. This opens the dialogue for the family to move from the stage of prompt-dependency to the development of personal autonomy (Monteiro, 2016, 2025).

In the initial stages, families often experience heightened distress, and therapeutic conversations typically focus on understanding how autism is shaping both the individual and family narratives. Once this foundational theme has been explored, the therapist can gradually introduce additional significant dimensions, such as challenges related to the family’s life cycle stage and other contextual and/or relational issues (e.g., divorce, chronic illness, or comorbidities). These themes are considered by examining how they intersect with the autistic individual’s needs, amplify or reduce family stress, and influence patterns of interaction. Integrating these contextual/relational factors into the ongoing narrative work enables the therapist to link current difficulties to broader systemic processes, tailor interventions to the family’s developmental stage, and support more adaptive meaning‑making across the individual and family system.

At the conclusion of each session, the therapist invites family members into a structured routine that prompts them to reflect on their key takeaways, reinforcing new perspectives and providing valuable insights into individual and family progress throughout the therapeutic process (Monteiro, 2016, 2025). Concurrently, the use of circular questioning encourages family members to adopt others’ perspectives, fostering empathy and understanding of each other’s thoughts and emotions. This practice serves as a training process that extends beyond therapy, promoting perspective-taking and relational growth in everyday interactions.

Table 1 presents an overview of the goals and processes for each session of systematic narrative family therapy for families with an individual with autism spectrum brain style differences.

Role of the therapist

Narrative therapists adopt a collaborative approach, prioritizing co-authoring with clients to create new narratives (Carr, 1998; Sequeira, 2021). They maintain transparency about the therapeutic process, intentions, and values, using the clients’ own language to ensure resonance and to strengthen the therapeutic relationship (Carr, 1998; Sequeira, 2021). Therapists explore multiple perspectives, emphasize active listening over questioning, and remains attentive to opportunities for opening space for alternative, empowering narratives (Carr, 1998; Sequeira, 2021).

In this approach, the therapist’s role is grounded in the ability to integrate the narrative family therapy approach while attending to the specificities of working with families that include an autistic member. This role has various interconnected layers throughout the therapeutic process. One of the layers is related to the practical aspects. The therapist should ensure that the context is tailored for the child/adolescent/young adult with a brain style on the autism spectrum (e.g., sensory-based manipulative materials and the introduction of the individual’s areas of preferred interest; visual presentation of information, modelling the need for contextualization by giving choices to answer). Then, he needs to foster connection by listening to and supporting each family member’s lived experiences and stories, while also building an individual relationship with each person, particularly with the member with brain style differences. The therapist should be mindful of empowering the individual with the autistic brain style to share their world view, creating a context to be heard and acknowledged by their experience.

By intentionally modeling the inclusion of the member with the autism spectrum brain style in therapeutic conversations, the therapist generates a contrasting lived experience in which the family witnesses that the autistic individual can participate as active and competent (Monteiro, 2016, 2025). This modeling supports a shift from deficit-framed narrative to a strength-based, co-authored narrative that repositions identity around strengths and differences (Monteiro, 2016, 2025). The therapist adopts a collaborative, neuro-affirming stance: observing and describing behavioral form and function using a descriptive language; offering reframes of behaviors, attitudes, and intentions; and inviting clarification (Monteiro, 2016, 2025).

Powerlessness is explicitly named and contrasted with emergent zones of choice (“continue the same pattern or doing something different”), opening possibilities for alternative action (Monteiro, 2016, 2025). The process involves identifying and amplifying singularities/ unique outcomes, eliciting details (what happened, what was thought, said, and done), and exploring their impact on the people involved, family interaction, and identity positions (Sequeira & Alarcão, 2013).

The therapist treats the family as the primary source of meaning—following their language, metaphors, and concerns—because sustainable solutions must be derived from their own experiential knowledge (Sequeira & Alarcão, 2013). In doing so, the model facilitates re-storying that both dismantles restrictive patterns and expands a repertoire of adaptive ways of understanding, speaking, and behaving in relation to the autistic brain style (Monteiro, 2016, 2025; Sequeira & Alarcão, 2013).

Simultaneously, we pay attention to each individual’s patterns of behavior, and interactions during the therapy, looking for optimal opportunities to engage in a three-step re-storying process. The three-step process involves the therapist noticing, commenting on what is happening in the moment, and checking for confirmation or clarification regarding the observational reframe (Monteiro, 2016, 2025). Additionally, the therapist must be attentive to and address communication styles (e.g., paradoxes) and the unspoken themes (e.g., themes avoided and/or difficult to speak).

This approach reminds the therapist to develop their self-other reflexivity by noticing their own emotional and physical responses, observing the effects of verbal and non-verbal communication on family members, recognizing moments of becoming “stuck”, identifying family resources, and showing appreciation (Hedges, 2005). Such acts of appreciation also serve to acknowledge the privilege inherent in accompanying the family through their therapeutic journey and development.

Therapeutic Techniques

Different therapeutic techniques are applied during the sessions, specifically narrative therapy and techniques from family therapy with autistic members. As our primary objective is to highlight the unique aspects of our work with families of individuals with autistic brain style, we provide only a brief description of the techniques. Effective techniques in therapeutic conversations always include the following: (1) systemic hypothesizing – organizing clients’ actions, the effects of events, and relationships, guiding therapeutic work; (2) circular questioning - promoting interpersonal perspective and creating new information/perspectives (Cecchin, 1987; Selvini et al., 1980; Telfener et al., 2025); (3) reframing – alternative conceptual or emotional perspective about the meaning of experiences; (4) positive connotation – considering individuals’ problematic behaviors, roles, etc., as functional, and having a positive function (Hedges, 2005).

Specific narrative therapy techniques include the following: (1) externalizing conversations - clients are separated from their problems and have agency over them (Carr, 1998; Combs & Freedman, 2012, 2016; White, 2007). The therapist must be careful about externalizing autism, as for some individuals, it may be part of their identity (Helps, 2016; J. S. Romney & Jones, 2020; Spain et al., 2017). (2) Singularities/unique outcomes – highlight moments when problem(s) was (were) absent, allowing clients to articulate preferred values and experiences through actions, feelings, statements, desires, dreams, thoughts, beliefs, abilities, or commitments (Carr, 1998; Combs & Freedman, 2012, 2016; Sequeira, 2021; Sequeira & Alarcão, 2013; White, 2007). These processes entail facilitating meaning-making by asking questions that develop an alternative narrative aligned with the client’s preferred self; (3) questions related to the landscape of action - focus on events, sequences, timing, and plot; (4) questions related to the landscape of identity - exploring meanings, effects, evaluations, and justifications (Carr, 1998; Combs & Freedman, 2012, 2016); (5) time frame questions - connecting unique outcomes to past events and extending them into the future, therapists help clients construct an alternative, preferred self-narrative in which they are empowered to view themselves as stronger than the problem (Carr, 1998; Combs & Freedman, 2012, 2016; White, 2007). Temporal linking enhances perceived competence and authorship, causal reframing replaces restrictive linear attributions with circular contextual explanations, and growing thematic diversity signals narrative broadening from problem-saturated stories to adaptive and complex meanings (Sequeira & Alarcão, 2013). Collectively, these shifts mark core therapeutic change processes in narrative family work and are typically associated with decreased of symptom salience (Sequeira & Alarcão, 2013). Narrative therapists often document new stories to amplify unique outcomes or incorporate them into rites of passage, reinforcing the client’s evolving narrative (Carr, 1998; Combs & Freedman, 2012, 2016; White, 2007).

The specific techniques used within this brief systematic narrative family therapy with autism will be described along with the suggested time frame for application (Table 2). Each technique must be carefully adapted to the individual’s unique autistic brain style and to the family, with the therapist using creative clinical strategies to tailor its application accordingly. To illustrate these adaptations in practice, we present case examples that demonstrate how each technique is applied across different stages of the therapeutic process, offering clinicians a clearer understanding of its implementation.

An illustrative case involves Arthur, an 18-year-old young man, his brother James (22 years old), and their parents (mother, 54 years old; father, 51 years old) in the first session. Arthur had begun to withdraw from the family and often voiced frustration with health and educational professionals, as well as with his parents, whom he felt did not fully believe in his abilities. His parents were also dealing with recurrent legal issues linked to Arthur’s intense interest in laws, legislation, and his strong sense of justice.

After initially engaging Arthur through his preferred interests, the therapist introduced a genogram activity, explaining that it would help the family look at themselves from a visual perspective. As she drew the nuclear family on the whiteboard and asked each person’s age, she also explored relevant themes, including James’s University experience, since this was closely connected to Arthur’s concerns about his own future educational path.

The therapist then invited the family to describe themselves in three words. The mother began by saying that they were autonomous/individualistic, explaining that each person had their own life and interests. She added that they often had disagreements and different points of view, sometimes about politics and sometimes about everyday matters. As the therapist clarified and summarized her ideas on the whiteboard, she wrote expressions such as “autonomous/individualistic,” “different points of view,” and “worried.”

The father partly agreed but emphasized that they were also a very close family. He explained that although each person was very individual, they could not stay away from one another for too long and tended to worry a great deal about each other. He added that the family was supportive and loving, especially when problems arose and had to be solved together. The mother nuanced this view by saying that this cohesion was more visible in critical moments than in everyday life, when work and routines left little time for meaningful contact. The father noted that he and the mother spent more time together than all four as a group, since each son tended to go to his own corner and interact little with them. The therapist reframed this pattern in light of the family’s life cycle stage.

As the conversation continued, both parents highlighted their concern for the children’s future and their wish to support them. The father described the family as supportive and full of love, while the mother acknowledged that affection was not openly expressed very often. She noted that they did not usually say things such as “I love you”, even though the feeling was present. The therapist reframed their concern as a way of expressing care and the desire for everyone in the family to be well, both individually and collectively. The father then stated clearly that they wanted James and Arthur to be happy, autonomous, and supported in whatever they chose to become, while also asking Arthur to communicate more openly so they could know how to help him.

The therapist noticed the emotional tone of the parents’ comments and invited reflection on how it felt to hear this. James said that, for him, it felt relatively neutral because his parents spoke naturally about it. Arthur appeared more agitated, but described it as normal in the context of what was happening at that moment. Both brothers agreed, however, that this kind of emotional conversation was not typical at home, which the therapist acknowledged as something new for the family.

When asked whether they agreed with their parents’ description of the family, James said he identified more with his mother’s view, particularly the ideas of individualism and different perspectives, though he did not fully reject his father’s description. Arthur also emphasized that the conversation itself felt unusual because the family rarely sat together and spoke in this way.

The therapist then invited the two brothers to contribute their own three words. Arthur described the family as “resilient,persistent,and hardworking”. When asked to give an example of resilience, he pointed to his mother’s way of handling difficult situations. The therapist linked persistence to the fact that the family had come to therapy, reinforcing his contribution and writing the three words next to his name on the board.

James chose “individualistic and honest”, and then added a third descriptor, which he explained as reflecting a pattern of worry driven by unnecessary fears. The therapist summarized this as “fears” and explored its meaning. James explained that he felt his parents worried excessively, as if he and Arthur were not capable of managing on their own. The therapist reflected that this seemed to complicate the family’s notion of autonomy: although they described themselves as autonomous, there was still a strong parental focus and vigilance. James agreed with this.

At the end, the therapist asked whether anything in others’ descriptions of the family had been surprising. The father highlighted “resilient,” while both parents also reacted to “honesty,” suggesting that these contributions had stood out for them. Overall, the exercise allowed multiple family narratives to emerge visually and collaboratively, bringing into the room tensions between autonomy and connection, support and overconcern, individuality and cohesion, while also creating space for emotional expression that was unusual in the family’s everyday life.

This exercise of describing the family can be extended to include descriptions of each individual family member. This approach is particularly useful with families whose members appear disengaged, as it fosters connection by encouraging members to view one another from each other’s perspectives. It is important for the clinician to reframe contributions and to use the whiteboard as a tool for visually organizing and systematizing the information shared.

To conclude the first session, the therapist invited the family to reflect on how this therapeutic space could be useful and to clarify their requests for therapy, and then facilitated a final reflective round in which each member shared what they were taking from the session. Both parents described it as a productive and meaningful experience that had helped strengthen family bonds. The father emphasized that it had been a long time since the four of them had spoken so openly together, while the mother highlighted that being outside their usual home environment had helped them stop, listen, and speak more honestly. She linked this to a family pattern in which everyone often talks but no one truly listens, and stressed the importance of having a dedicated sharing space. Both parents felt the session had exceeded their expectations, especially because, despite many previous therapeutic experiences centered on Arthur, they had never engaged in this kind of family conversation.

James’s reflection was more reserved, but he noted that the session confirmed that, despite everything, family members do know one another. Arthur was more ambivalent, describing the session as normal and not necessarily very beneficial, yet still acknowledging that it might be worth continuing. Overall, this closing routine allowed the therapist to consolidate the session, clarify therapeutic goals, and reveal different levels of engagement within the family.

Emotional, social, and sensory demands commonly trigger dysregulation in children, adolescents, and young adults with brain style differences. These challenges affect the individual and the family system. Patterns of expression may differ across individuals, for example, some may show more outwardly reactive behaviors, while others may turn distress inward. When the brain shifts from a calm to a reactive state, episodes of self-injury, aggression toward others or objects, or the use of indiscriminate language may occur. Such behaviors are often interpreted as intentional through a social lens. However, in autism, a social lens is inadequate to account for the sensory and regulatory processes driving these responses. Accordingly, the therapist must work at the interface of social context, sensory thresholds, and self-regulation abilities. The Self-Regulation Scale supports this work by helping clinicians, parents, and the autistic individual identify early signals of escalating arousal and facilitate brain reset breaks. This collaborative monitoring and intervention aim to prevent escalation into reactive states that, in past episodes, have resulted in harmful behaviors or verbally aggressive outbursts used to avoid overwhelming demands.

The practical application of this technique can be seen in the following case example, which uses the whiteboard to develop awareness of signals and to co-construct strategies. Mark (18 years old), a highly intelligent young adult with a low self-regulation threshold and a primary interest in Manga, illustrates this process. His sessions were conducted with his mother (48 years old) and older sister (24 years old), within the context of a binuclear family. Mark experienced frequent dysregulation, often expressed with routines of physical aggression toward objects. The Self‑Regulation Scale was introduced during the second therapy session, after the mother recalled earlier situations involving Mark and his sister, in which she had to manage his reactive behavior, while they were growing up. The following interaction shows how Mark understood both his past and current reactions, the impact these behaviors had on himself and others, and how he attempted to communicate when his emotional threshold was being exceeded.

In the therapeutic conversation, Mark’s mother and sister described a recurrent pattern: when Mark became overwhelmed, he seemed to “switch off,” reacting without reflection, and then returning to himself once the episode had passed. When the therapist asked Mark whether he shared this perception, he agreed, explaining that although in the past he had little awareness of the impact on others, more recently he had begun to recognize it. After hearing from the mother that there were times when she may not have given him enough space to calm down, the therapist introduced the self-regulation technique: “So,if this were a scale,and I’m going to put it here (goes to the board to write). If this were a scale from 1 to 5,where one is Mark’s calm state and (…) 5 is that situation where you feel you’re already out of yourself,right? Where you’re not aware of the consequences or the impact you’re having on others. We have level one,two,three,four,and five. At what point do you think you start to lose control?”

With the therapist, Mark and his sister identified level 3 as the key turning point in the escalation cycle. At this stage, Mark described feeling anger and irritation, and he also explained that his feelings could become more aggressive depending on the person involved. To illustrate this, he shared an episode from school in which a classmate repeatedly provoked him despite warnings to stop, until he eventually punched him. Reflecting on this, Mark located that moment around level 4 rather than level 5, allowing the therapist to mark level 4 on the board as the point where aggressive behavior toward another person emerged.

The therapist then explored whether this escalation could also shift from aggression toward others to aggression toward himself. Mark acknowledged that in the past this had happened often, usually very close to level 5. His sister described this as a continuum: if another person continued to provoke him, the aggression could turn inward. The therapist represented this visually on the board, drawing an arrow from hetero aggression at level 4 to self-aggression at level 5. When asked what he felt at level 4, Mark first expressed violent thoughts about physically stopping the other person, which the therapist distinguished from emotion and wrote down as thoughts. He then identified the feeling itself as hatred. His mother added that he also frequently slammed doors or threw objects. Mark explained that, in those moments, he was releasing something onto an object instead of a living being. The therapist reframed this as a form of communication, namely “leave me alone,” and Mark agreed, clarifying that before this point he does try to warn people verbally by saying things such as “stop” or “leave me alone.” The therapist therefore noted on the board that, at level 3, Mark still retained verbal communication, but from level 3 to 4 his capacity to express himself decreased and his reactions became, in his own words, more instinctive or “animalistic.” To capture this shift, the therapist drew a second visual aid on the board: a T-chart (Monteiro, 2016) contrasting “thinking” with “reacting,” and together they identified that this higher level of escalation was driven by the reactive brain part.

The conversation then moved toward what helped Mark regulate himself and came back down the scale. His mother raised the example of when he runs away physically from the situation, and Mark explained that he does this to de-stress, calm down, and have time alone. His sister added that this had long been taught as a strategy: when the situation is escalating, he leaves. She emphasized that level 3 remains a crucial turning point because at that stage he can still return to calm if the context allows it. Mark and his sister both noted that escalation always depends not only on him but also on the context, the other person’s reaction, and even the tone of voice used. The therapist highlighted that behaviors therefore need to be understood within context, and that the object aggression or self-aggression was part of his communication when verbal expression was no longer available.

Finally, the therapist asked what helps calm him at level 3 and wrote these resources on the whiteboard. Mark identified taking a long walk, seeking external support from trusted friends, calling his sister, and listening to music. His sister added that taking a break from the situation: leaving the context, doing something else, and returning later when calmer helped him regulate. The therapist then labeled all the strategies as his “Brain Reset Break,” writing it on the board. Mark and his sister both agreed that this captured the process well: it involved resetting emotions, thoughts, and behavior so that conversation could resume later from a calmer state. Overall, this technique allowed the therapist, Mark, and his family to map escalation visually through the Self-Regulation Scale, the thinking/reacting T-chart, and the idea of a Brain Reset Break, helping to translate Mark’s dysregulation into a shared language of thresholds, communication, and regulation strategies.

The Self-Regulation Scale framework used for levels 3 to 5 can also be applied to levels 0 to 2 to explore how the individual thinks, feels, and behaves. In this case, the young adult is able to articulate and describe his perception of his past and present reactive behavioral patterns. However, this exercise may be more challenging for younger children, adolescents, or individuals who require higher levels of support. In such cases, it may be helpful to incorporate observations from parents and siblings regarding triggers and behaviors during reactive episodes, taking the individual’s brain style differences into account.

As the therapeutic process progresses, we implement the Brain Style Profile, in which the therapist collaborates with the family to explore strengths and differences across three key domains: (1) language and communication, (2) social relationships and emotional responses, and (3) sensory use and interests (Monteiro, 2016, 2025). Although this component is informed by the Monteiro Interview Guidelines for Diagnosing Autism Spectrum - 2nd Edition (MIGDAS-2)(Monteiro & Stegall, 2018) assessment administered prior to the therapeutic process, an experienced therapist is also able to introduce these domains organically during sessions by observing, commenting on, and clarifying with the individual and family their understanding of the form and function of behaviors.

In session, the Brain Style Profile is conducted collaboratively, allowing both the family and the individual with an autistic brain style to contribute with observations and identify additional aspects they consider relevant. The therapist uses the whiteboard to visually organize each domain, beginning with strengths and subsequently exploring differences. Depending on the individual’s brain style, it may be beneficial to involve the child or adolescent directly by inviting them to write or draw on the board, thereby providing an active and meaningful role in constructing the profile.

This collaborative process is illustrated in the case of Paul (18 years old) and his brother Felix (15 years old), both with brain style differences, and their parents. Paul showed a systematic, sequential, and careful thinking style, together with a strong tendency to connect with others by sharing his preferred interests. Felix, by contrast, had a brain style marked by a need for tactile and movement-based input and a low threshold for verbal input.

In session, the therapist introduced the Brain Style Profile: “Look Paul,now we are going to talk about your brain style! And I am going to write on the board over there (.) When we talk about brain style,we are talking about the way we learn and the way we function. Okay?” She then began to build his profile collaboratively, first focusing on “Language and Communication”. This visual structure helped make the process concrete and accessible.

As the therapist explored Paul’s communication strengths, she highlighted his well-developed language skills and his ability to communicate clearly about what he needs and wants. Paul agreed with this description. She then asked whether he was able to maintain conversations with other people, and again he responded positively. To make this more specific and meaningful, the therapist connected the discussion to Paul’s preferred interests, particularly music bands. This immediately engaged him and prompted a visible positive response, which the therapist used to underline that conversation became especially easy and fluent when it involved topics that mattered to him. She also noted on the board that, in these situations, he was able not only to sustain interaction but also to contribute facts, details, and information.

The therapist further identified one of Paul’s characteristic language patterns: his frequent use of the word “right?” at the end of his sentences. She reframed it as a communicative strength. She explained that by saying “right?” Paul was inviting the other person to join in, respond, and extend the exchange. In this way, the therapist turned a concrete speech habit into a visible example of how Paul creates opportunities for reciprocity in conversation.

Overall, the exchange illustrates how the therapist used the whiteboard activity to co-construct a brain style profile that was both affirming and practical. By organizing the discussion visually, linking it to Paul’s interests, and reframing specific communication features as strengths, she supported a collaborative and accessible understanding of how he engages with others.

This work proceeds by exploring both strengths and differences across each of the three core domains. For a more detailed and comprehensive presentation of the autism spectrum Brain Style framework, readers are referred to (Monteiro, 2016, 2025).

The Magic Wand technique (M. Monteiro, personal communication, August 28, 2024) reinforces the idea that the capacity for change lies with the individual and the family, emphasizing their agency in deciding whether to maintain current patterns or adopt more adaptive ways of engaging. This is illustrated in the sixth session with Tyler, a highly intelligent 12-year-old with absolute pitch and several sensory particularities, and his parents. At the end of the session, after the structured routine question. The therapist introduced: “I’d like to build on this; on this very sincere and honest sharing,not from a place of fear that may be present. And I want to share with you that change has already begun,and you have already started doing that. You’ve already been doing things differently. And today you clearly showed me that here,didn’t you? The things you’ve been doing outside of here that are working. And connecting this with what Dad said earlier: « I hope this lasts until Christmas! » Sometimes changes take time before they become established. (…) So,look (picks up a sensory object, like a glitter wand and show them), why did I bring this wand today? There’s a very special reason: to give you the power of change! Because it’s not in me; it’s in you! You can all hold it. (all three hold it) This is the power of change that goes with you,and that is already within you,because you’ve already been working hard to do things differently. And it goes home with you!”

Role reversal, in turn, facilitates perspective-taking by helping the autistic individual reflect on their own behavior, its impact on others, and possible alternative ways of acting. This was illustrated in the third session with Brian, a 13-year-old boy, and his parents, a binuclear family adjusting to a recent divorce. Brian’s brain style was marked by a constant need for movement and tactile sensory routines, as well as a tendency to approach difficult subjects through humor or scripted phrases. For example, when the therapist addressed the topic of the divorce, he responded to the routine end of session question with the following sentence: “Lavoisier (pause) nothing is lost,everything is transformed!”

His parents explained that both Brian and his mother shared a cognitive style characterized by intense focus on a single activity, and that when Brian was engaged in preferred activities he struggled with transitions, often expressing his needs abruptly and with escalating vocal and physical intensity. To explore this pattern, the therapist proposed a role-reversal exercise in which Brian and his father switched seats. Then, the father acted as Brian during a common situation in which gaming time had ended, while Brian played the role of his father. In the first enactment, the father imitated Brian’s usual reaction by shouting, stomping, and demanding more time, while Brian, playing his father, responded minimally and calmly. Afterwards, the therapist invited them to repeat the scene, but this time with the father acting as Brian in the way he believed would be more effective and comfortable, asking more calmly and directly for extra time. Brian, acting as the father, responded positively, and the contrast between the two versions became clear.

The exercise then opened space for reflection. Brian was able to acknowledge that he could probably approach the situation more calmly and manage it better, even though he also insisted that his father often took too long to respond and that speed mattered to him in the moment. When the therapist invited him to think about how his father might feel when he was approached so intensely, Brian initially found this difficult and said he could not know what other people think. However, with support, he began considering that his father might feel angry or affected by the abruptness of the interaction, while the father added that he often felt startled by the sudden escalation. The therapist linked this discussion to the Self-Regulation Scale already on the board, using it to help Brian think about the emotional state of the other person as well as his own. This technique used seat switching and embodied enactment to make interactional patterns visible and to promote perspective-taking and alternative responses.

The family superpowers technique enables the clinician to explore how each family member perceives their own strengths and the strengths of others. To illustrate the application of this technique, we present a structured example drawn from its use during the eighth session with Tyler’s family. The therapist introduces in the middle of the session: “Okay,I was listening to you,and I brought an exercise for us to do today. And it connects a bit with what we were just talking about,which is: if old patterns come back,right? What have you learned about yourselves that can help you deal with them? So,the challenge is for you to identify your own superpowers (one or more),and the superpowers of the other family members! Okay? So,for example,Tyler will choose one superpower for himself,one superpower for Mom,and one superpower for Dad,alright? Do you accept the challenge?”

Using a set of “superpower” cards, including blank cards for creating new labels, the therapist suggested that they could invent superhero names, framing the task as a collaborative and playful activity. Tyler engaged immediately, noting he had already selected all three, while the therapist placed pens and materials in the center and encouraged each person to choose different superpowers. The father began by selecting for Tyler the card “knowing how to make mistakes,” linking it to situations in which Tyler had faced challenges, such as learning to ride a bicycle or coping with bus journeys, and emphasizing that Tyler could persist even when he felt apprehensive or initially unsuccessful. The therapist placed this card on the board under Tyler’s name. The mother then chose “communication,” explaining that Tyler had become more able to express his feelings, explain himself, and communicate ideas in ways that allowed the family to understand him and respond more effectively. Tyler interpreted this partly in terms of growing confidence, and the mother reflected that communication had improved not only in session but also at home, as the family had become more receptive to listening. Tyler then added “genuineness” as another of his own superpowers, which the therapist read aloud from the card as not being ashamed of who one is and being able to show what one feels, thinks, and needs. The father reinforced this by noting that Tyler genuinely says what he thinks.

The activity then moved to the mother. The father identified “organization” as her superpower, humorously noting that without her, neither he nor Tyler would manage to organize anything. The mother chose “resilience” for herself, explaining that she never gives up despite difficulties and continues trying to support Tyler, including with things such as studying. Tyler, however, offered his own formulation on a blank card: “dedication to the family.” When the therapist invited him to explain, he said that whenever she can, his mother tries to help the whole family, even people she may not particularly like. This moved the mother, who acknowledged that although she knew Tyler was aware of her efforts, hearing him recognize it so explicitly was surprising. The father linked this moment to the broader issue of gratitude and recognition, noting how painful it can be when effort goes unseen and how this may also apply to Tyler when he feels his own efforts are not reinforced. The therapist connected this to a wider shift she had noticed in recent sessions: family members were becoming more able to express feelings such as anxiety or relief, and this growing emotional sharing could also extend to recognition and gratitude.

The session then continued with the father’s superpowers: “acceptance,” chosen by himself, “cooperation,” chosen by his wife, and “persistence,” chosen by Tyler. Throughout the exercise, the therapist explored what was surprising or unexpected in these attributions. This created opportunities for family members to take in new perspectives about one another and to compare earlier interactional patterns with the more reflective and appreciative dynamics that were beginning to emerge both in therapy and in everyday family life.

Finally, at the end of the therapeutic process, the therapist introduces the Brain Style Book as a closing ritual that both marks the conclusion of therapy and opens space for future challenges and growth for the individual and their family. To illustrate this process, we present the case of David (12 years old), whose brain style included a strong need for movement routines and sound production. The eighth session was conducted with his parents (both 43 years old). The therapist showed two book options aligned with David’s areas of interest and, after David makes his selection, introduces the Brain Style Book as follows: “This is the book,and it’s for you,David! It has all these blank pages so you can write about yourself,about your family,about whatever you want.”

David: “Is it a diary?”

Therapist: “For example! But it has something very special here,which is this: this is your brain style. The one we created at the beginning and talked about together (…) Here,in different areas,you have your strengths and your differences. And then I added this part with your family’s superheroes,right? (they look attentively) Son of God,which is David,Moon Man,and Luna! Right? (…)”.

Father: “Look,even our symbols are here!”

Therapist: “…not all superheroes wear capes,right? And here are your superpowers! (…) And I thought that metaphor you used was so good,David,that I decided to include here the metaphor of the cocoon and the butterfly.”

David: “Yes.”

Therapist: “Because that represents your family’s journey! Right? As a family,you evolve,you grow; not only as a family,but also as individuals. Isn’t that so? You,David,your father,and your mother! (Mother becomes emotional, the father too; they look at David. David gets up to hug his parents.) And now you are able to express your emotions,just as you said so well! (David approaches the therapist and gives her a side hug) Thank you! (silence) Isn’t that right,David? (parents visibly emotional) This is a journey!”

Father: “This hug that therapist received is a special one (…)”.

In the end, this technique enables the clinician to revisit the sessions and the processes that emerged, consolidating them into a coherent narrative.

Discussion

This paper provides a brief systematic narrative family therapy protocol for clinicians working with families of individuals with the autistic brain style. This approach underscores the need for therapists to acknowledge key aspects when working with these families.

As narrative therapists, we employed the Korzybski (1941) metaphor, “The map is not the territory,” to clarify that our goal in this paper is to offer a roadmap. Therapy must always consider each family’s specific circumstances and challenges, since their lived reality is inevitably more complex and nuanced. The case examples are meant to enrich this roadmap and help therapists respond more sensitively to the unique experience of each family.

This work is particularly relevant given the rising prevalence of autism and the corresponding need to support not only the individual but also the broader family system. This point is consistently emphasized in the literature, which highlights the importance of interventions that engage the whole family rather than focusing exclusively on the diagnosed individual (Cridland et al., 2014; Karst & van Hecke, 2012; Romney & Jones, 2020; Spain et al., 2017). Families living with an individual who has an autism spectrum brain style often experience elevated levels of anxiety, stress, and social isolation (Houser et al., 2014; Romney et al., 2020; Salari et al., 2022). Research further shows that these families function through transactional and bidirectional patterns of influence, in which each member’s well-being both affects and is affected by the family’s interactional dynamics as a whole (Da Paz & Wallander, 2017; Dallos et al., 2019; Karst & van Hecke, 2012; McKenzie et al., 2021; Spain et al., 2017). Interventions should therefore strengthen protective factors such as communication, cohesion, and adaptability, which are linked to family satisfaction.

Communication is central because it helps families move between cohesion and flexibility and respond to changing demands (Olson, 2011; Sequeira et al., 2021). In line with Olson’s Circumplex Model, balanced families tend to report better communication and greater satisfaction (Olson, 2011; Sequeira et al., 2021), while higher adaptability is associated with both family resilience and more positive outcomes in families raising autistic children (Grigoropoulos, 2022; Patterson, 1988).

Strengthening these relational dimensions may also reduce longer-term stressors, such as marital strain or divorce, comorbidities, and developmental challenges. Importantly, shifting from an autism-centered narrative to one focused on the individual’s lived story helps families understand their child’s needs and develop strategies that are more tailored, adaptive, and sustainable within the family system (Monteiro, 2016, 2025).

Regarding the implementation of this protocol, we outline four key aspects of working with families that include an individual with an autistic brain style.

First, when a family receives an autism spectrum disorder diagnosis, they are presented with a DSM-5-based list of deficits, framing a deficit-focused narrative - diagnostic map. However, knowing an individual with an autism spectrum brain style requires an understanding of their unique profile. In the presented approach, we adopt a neuro-affirming, strength-based approach, using descriptive language to construct and change meaning, and highlight patterns of strengths and differences in communication, social-emotional responses, and sensory interests, as outlined in Monteiro’s (2016, 2025) autism Descriptive Triangle. This approach emphasizes the function of behaviors, reflecting the individual’s lived experience and enabling adaptive, functional sharing with significant others. By contextualizing the autism spectrum diagnosis, we help families and clinicians recognize individual patterns, empowering parents as experts in their child’s journey (Monteiro, 2016, 2025).

Second, this protocol provides a structured intervention map although only through direct engagement with families can therapists explore their distinct “territory.” The flexibility allows clinicians to selectively apply elements of the protocol as needed. Importantly, therapists should recognize that a family’s “story” comprises interconnected storylines, akin to a map’s lines representing their complex territory.

Third, creativity is an important aspect when working with individuals with an autistic brain style. The therapist should be in sync with the individual’s communication style, preferred areas of interest and their sensory profile. These aspects are very important to acknowledge and to adopt a collaborative, respectful posture when interacting and communicating with them, which will model further interactions within the family. This gradual and progressive process occurs throughout therapy to promote healthy family interactions.

Finally, clinicians working with families of individuals with autism spectrum brain styles should value the autistic individual’s unique perspectives, kind nature, and willingness of families to share profound challenges and transformative changes. Likewise, therapists must be open to engage with the intense emotions and significant moments that arise during these interactions. We must recognize that therapy changes both clients and therapists (Carr, 1998), but our role is to support people in claiming a position as privileged authors of their own lives and stories (Combs & Freedman, 2012, 2016).

Conclusion

This paper advances a brief, systematized and structured framework for applying existing narrative and systemic approaches to family therapy for families with autism spectrum brain style members. The proposed protocol offers a roadmap and a framework for narrative family therapists, who must navigate each family’s unique reality while adapting to individual brain style differences. By providing a structured yet flexible roadmap, this model supports therapists in cultivating meaningful connections and facilitating therapeutic change. Ultimately, the overarching goal for both families and individuals with an autism spectrum brain style is to enhance their overall well-being and to strengthen the connections within the family system.