While recently giving a presentation on counseling clients with autism spectrum disorder (ASD), I had a more than professional concern: I am on the spectrum as well. Not that far along, true, but still on it, and if you were not to suspect this meeting me, it is only because a lifetime of learning to function successfully in the neurotypical world has borne fruit. As an autistic clinician, I offer these insights to help colleagues better understand and effectively support neuroalternate clients. (Note: “Neuroalternate” is a term I have personally coined and will be used in place of the clinical term “neurodivergent” for the purposes of this article.)

What is the Neuroalternative Experience?

The neuroalternate experience is like listening to someone who is not a native speaker of your language; while you may understand them, it takes extra effort. In contrast to a richly diverse and kinetic environment, what we prefer, long for, and even need is one that is straightforward, structured, predictable, and low in stimulation. Any deviation from this is unwelcome, stressful, and overloads our circuits. Social rituals and expectations appear strange and nonsensical, and the cues that accompany them are perplexing and inscrutable. There seems no good reason to pay attention to them (despite often getting us, obviously, into hot water).

Direct Communication: Clarity Over Social Rituals

From a neuroalternate perspective, communication the way we want it is direct and straightforward, even blunt. There’s no need for niceties. Just say what you mean, mean what you say, and get on with it. Keeping up with a group conversation is like keeping your eyes on each ant in a swarm of ants. Sarcasm, double meanings, plays on words, idioms, and colloquialisms can go over our heads. Thus, we can sometimes come across as painfully earnest in conversation. True, we don’t enjoy the misunderstandings resulting from all this, but it’s hard for us to see what to do about them. That’s where counseling comes in.

Key Considerations for Clinicians Working with Neuroalternate Clients

Drawing from my clinical experience and personal perspective as an autistic counselor, here are key insights for working with neuroalternate clients.

1. Don’t try to make them into someone they’re not and can’t be. By the time they get to us, most clients are already beaten up by years of expectations they cannot meet and have failed at, leaving them feeling excluded and often ashamed.
2. Remember that neuroalternates do have a need for human relationships. However, after repeated collisions with the neurotypical world, isolation becomes preferable to pain.
3. Accept that to the neuroalternate, relationships built purely on social interactions – hanging out, chatting, bantering – will likely be unrewarding. Likewise, acknowledge that acquiring an instinctive feel for social cues will not happen. It would be like trying to get someone who is color-blind to see color.
4. Use concepts from physical objects to engage. Neuroalternates are drawn to concrete things, so progress can be made on this basis. Think of signals or gauges; if we know what they mean, we can react even if we do not understand the processes behind them. Thus, identifying social cues and learning how to respond to them must be framed in terms of reading instruments that tell the operator to take specific actions. To a neurotypical, this may come across as mechanistic and off-putting; however, it is something the neuroalternate mind can embrace and work with.
5. Be quiet, calm, and patient, and let the client approach you. Buy-in – the alliance – is even more critical than with other clients, since change can feel especially threatening to the neuroalternate client’s sense of self. Reassure them that you will help them learn to cope with the world only as much as they need to yet still remain themselves.

In conclusion, think of a brick wall, with the neurotypical as the bricks and the neuroalternate the mortar. Stacking the bricks on top of one another would result in a wall that is easy to push over. Likewise, mortar by itself does not a wall make. But with mortar to hold the bricks in place, you get a strong and lasting wall. We need each other.

About the Author

James P. Bruner is the high school ASACS counselor in Vicenza, Italy. He has been with ASACS since 2001 and served at three sites in Germany prior to moving to Italy. He grew up in the Upper Ohio Valley and will eventually move with his wife to be with their family in Oklahoma. His interests are in anything that’s alive, any kind of machinery, and any kind of science – frankly, just about anything.

On March 27, 2025, Faith Best, LCSW, Director of Clinical Services at NeuroFlow, led an energizing 15-minute webinar, Invest in Rest, exploring the critical role sleep plays in overall wellbeing. This dynamic session offered practical insights to help participants recognize the signs of poor sleep and discover simple, effective strategies to improve bedtime routines.

Whether you joined us live or are catching up now, this recap highlights key takeaways from the session, empowering you to prioritize sleep to improve your daily life and long-term health. Let’s get started!

What is the connection between sleep and mental and physical health?

The importance of sleep cannot be overstated. Approximately one-third of Americans are chronically sleep-deprived, a number that continues to rise as screen time, working hours and stress levels increase. As a result, both the duration and quality of sleep are declining, impacting physical and mental health in expected and unexpected ways.

During sleep, the body undergoes essential maintenance processes that cannot occur while awake. This includes memory consolidation, cognitive processing, immune system strengthening and hormone regulation, including stress hormones.

Chronic sleep deprivation has been linked to health conditions such as heart disease, high blood pressure and stroke. It can impair brain function, decision-making and reaction time. The fogginess and fatigue from inadequate sleep are well known, and poor sleep has also been shown to increase anxiety and depressive symptoms. This can create a vicious cycle where heightened stress and low mood further disrupt sleep, worsening overall mental health.

A recent study by NeuroFlow found that deteriorating sleep was even associated with an increased risk of suicidal ideation. Sleep deprivation can feel torturous, and its effects on the body and mind are profound. Prioritizing sleep is essential for overall wellbeing.

What are some ways to improve sleep quality if getting more hours of sleep isn’t an option?

When it’s time to sleep, the mind can start racing, or restlessness can make it difficult to relax and take advantage of the time available. Here are two techniques—one focused on the mind and one on the body—that can help improve relaxation and sleep.

The first technique is called “worry time.” It’s common for anxious thoughts to surface at bedtime, even if they do not appear throughout the day. A proven method to reduce nighttime worry is to schedule a specific time to focus on those thoughts during the day. Choosing a consistent time, such as during a commute or another daily routine, can help. Setting a reminder can also reinforce this habit. During that scheduled time, allow worries to come, acknowledge them, and reflect on them. Then, if those thoughts arise at night, it becomes easier to remind the mind that time has already been set aside for them, reducing their intrusion at bedtime.

The second technique is progressive muscle relaxation, which helps the body release tension before sleep. Even when lying down, muscles may remain tense due to stress, pain or habitual posture. This method involves consciously relaxing different muscle groups one at a time. Starting from the toes and moving upward, tense each muscle group for a few seconds while inhaling, then release the tension while exhaling. Continuing this process through the entire body can significantly improve relaxation. For those new to the technique, guided videos can be found online to walk through the process. This practice not only helps relax the body but also serves as a mindfulness technique, increasing awareness of physical sensations and creating a sense of calm that prepares the body and mind for restful sleep.

How can I calm down for bed, so I wake up rested?

Many adults expect to easily fall asleep after a long day of working, parenting, watching TV or scrolling through social media. However, just like children benefit from a bedtime routine, adults also need a way to transition into restful sleep.

Consistency is one of the most important factors in quality sleep. While it’s widely known that seven to nine hours of sleep per night is recommended, the consistency and quality of that sleep are just as crucial. A regular bedtime and wake-up time help the body establish a rhythm, allowing it to function optimally.

Building a bedtime routine that promotes relaxation is key. Just as children wind down with a bath or bedtime story, adults can incorporate activities that calm the mind and body. This could include progressive muscle relaxation, stretching or other relaxation methods that work best for individual needs.

For those who experience discomfort, such as back or hip pain, incorporating a short stretching routine before bed can be beneficial. A simple 10-minute stretch can not only relieve physical tension but also help signal to the mind that it’s time to unwind. When a routine becomes a habit, the body begins to recognize the cues and prepares for sleep more effectively.

Preparing the mind for sleep is just as important as preparing the body. Activities like journaling, meditation or scheduling time to process thoughts can help clear the mind before bed. Writing down worries or reflections can create a sense of closure for the day, making it easier to relax.

Keeping routines as simple as possible increases the likelihood of sticking to them. Mobile applications can be valuable tools for guiding activities like stretching or relaxation, eliminating the burden of planning your next steps. The NeuroFlow app is particularly effective, offering guided videos for yoga, meditation and breathing exercises to support relaxation. For those seeking structured sleep improvement techniques, digital cognitive behavioral therapy programs like Magellan Healthcare’s Restore provides step-by-step guidance, including proven techniques and exercises designed to improve sleep quality. Finding the right tools to simplify and support a sleep routine can make all the difference in achieving restful, restorative sleep.

How does technology like screen time impact our ability to get quality rest and what can we do to minimize its quality?

Many apps and videos are designed to be engaging and stimulating, encouraging continued use rather than promoting relaxation. This can make it more difficult to fall asleep. The most effective approach is to avoid screens for about 30 to 60 minutes before bed. Utilizing phone settings to limit notifications or restrict access to certain apps can help minimize distractions and reduce the temptation to use screens at bedtime.

The connection between sleep and both mental and physical health is undeniable. Quality sleep is essential for the body to perform vital maintenance processes, from cognitive functioning to immune support and stress regulation. Chronic sleep deprivation can lead to a range of serious health issues, both physically and mentally, including heart disease, impaired brain function and mood disorders like anxiety and depression. While factors such as stress and screen time may disrupt sleep, there are strategies to improve both the quantity and quality of rest. Techniques like “worry time” and progressive muscle relaxation, along with consistent bedtime routines, can significantly enhance relaxation and readiness for sleep. Reducing screen time before bed further supports this process. Prioritizing and improving sleep habits is an investment in overall wellbeing, making it essential to incorporate restful practices into daily life for better health outcomes.

If you missed the Magellan Minute, listen to the recording here.

Source: CDC

Autism Acceptance Month celebrates the unique strengths of individuals with autism spectrum disorder (ASD) while promoting understanding and support for their needs. ASD affects 1 in 36 children and an estimated five million adults in the U.S. Many face co-occurring mental and physical conditions, requiring holistic care to support their overall wellbeing.

Why acceptance matters

Acceptance creates opportunities and builds a sense of belonging. When individuals with autism are accepted and supported:

• Early intervention becomes possible. Diagnosing autism early enables access to therapies, such as Applied Behavior Analysis (ABA), that improve communication and social skills, promoting independence and meaningful connections.
• Barriers are broken down. Approximately 85% of adults with autism are unemployed or underemployed. Increased awareness and support can help overcome challenges in education, employment and healthcare, creating opportunities for inclusion and success.

Why co-occurring conditions matter

Co-occurring conditions often significantly impact the lives of individuals with ASD.

• Physical health conditions, such as gastrointestinal issues, epilepsy and sleep disorders, affect approximately 50 – 70% of children with ASD.
• Mental health conditions, like anxiety, depression and attention-deficit hyperactivity disorder (ADHD), impact up to 80% of adults with ASD.

Addressing these co-occurring conditions in tandem with ASD improves quality of life, strengthens relationships and promotes greater independence.

How you can make a difference

• Learn: Educate yourself about autism and co-occurring conditions.
• Advocate: Promote participation in schools, workplaces and communities.
• Amplify: Celebrate the strengths and perspectives of individuals with ASD.

Together, we can create a world that embraces neurodiversity, fosters acceptance and empowers individuals with ASD to thrive.

Visit MagellanHealthcare.com/Autism-Resources for more information and helpful resources.

March marks National Social Work Month, a time to honor social workers, who have an essential role in supporting individuals facing mental health challenges, substance use disorders, and complex life circumstances. Their dedication to advocacy and client-centered care strengthens those individuals, their families and communities. Social workers bridge gaps in care and promote recovery. This month we celebrate their commitment to helping individuals live healthy vibrant lives. We’re spotlighting two of Magellan Health’s social workers who share their experiences in this field:

• Tracy Felton, director of capture management, joined Magellan Federal in May 2015.
• David Bieschke, director, clinical care services, joined Magellan in April 2007.

Continue reading to learn more from Tracy and David on their experiences as social workers:

Why did you become a social worker and what is the most rewarding aspect of working in this field?

Tracy: I have always been passionate about helping people, even as a young child, as a babysitter, camp counselor and community volunteer. I saw disparities in the lives of people I served and felt I wanted to make a difference by helping people pursue the lives they wanted to have. The most rewarding aspect of this field is the flexibility of the various roles I have served as a social worker. From diverse populations with children and families impacted by substance abuse and behavioral health issues to military service members and their families whose quality of life is paramount to mission readiness. Working in Philadelphia, New Haven and Washington, D.C, brings complex challenges and great opportunities to see incredible resiliency at work in often dire circumstances.

David: I became a social worker initially because I was adopted and wanted to work with other adoptees and their families. The most rewarding aspect of working in this field is being able to help others realize they have healthy choices they can make in life, both at the micro and macro level.

What are some challenges you face being a social worker, and how do you overcome them?

Tracy: Continued funding for adequate staffing, competitive salaries and program resources has become more challenging post-COVID. The country’s behavioral health crisis has increased requirements for well-trained, experienced social workers in many service capacities. The shortage of social workers means services are not being rendered, and the most severely ill remain so. With this shortage, those who remain committed to the mission and work tirelessly are more apt to experience severe burnout.

David: There are many challenges, but one I work to overcome every day is the stigma of what a social worker is and what they do in their professional role. My professional achievements have been an example of what depth a social worker can have in their career. When the opportunity arises, I educate others about the various roles social workers play, most particularly, with managed behavioral healthcare.

Is there anything you’d like to highlight about working in this field?

Tracy: The resilience of the human spirit and the creativity individuals and families embrace to survive and thrive is always remarkable. Watching a new mother living in a housing project, whose utilities were turned off, have the ingenious idea to put breast milk in the snow outside her door to stay cold showed me she would persevere. Partnering with such clients has given me so much joy and gratitude.

David: The social work profession has come a long way since I received my bachelor’s degree in social work in 1984. The profession has grown and diversified in all areas of behavioral health, and now more than ever there are numerous opportunities for social workers to make an impact on people’s lives.

What does National Social Worker Month mean to you?

Tracy: This is a time when we stop, focus and celebrate the incredible contributions that social workers have made to help individuals, families and communities to reach their full potential. The theme “Social Work: Compassion + Action” highlights my dedication and commitment through many years of education and training, working with remarkable clients and brilliant colleagues. I view my professional world and everything I do in it through the lens of being a social worker first. I am proud to be a social worker!

David: It means an opportunity to acknowledge the profession and to honor my social worker colleagues for their commitment and good work they do every day.

Observed during the third full week of March (March 16-22), National Drug and Alcohol Facts Week aims to inspire dialogue and offer education about the science of drug use and addiction. A number of surprising facts illustrate the seriousness of the issue today.

• Alcohol is the most commonly abused substance and the third most common cause of death in the U.S. Although legal, alcohol kills over 95,150 Americans each year.
• Thirteen is the average age at which children experiment with drugs.
• An estimated 60% of poor work performance can be tied to drug or alcohol use.
• 138 million Americans age 12 and over drink alcohol, and 20.4% of them have an alcohol use disorder.
• Common reactions to substance use include needing to consume more to get the same effect; substance dependency; painful withdrawal symptoms; high blood pressure and stroke; problems with the liver and pancreas; development of certain cancers; loss of motivation; depression and anxiety.

Visit MagellanHealthcare.com/about/bh-resources/mymh or call your program for confidential mental health resources.

Physical wellbeing: tips for maintaining a health body.

• Keep your physical wellbeing high on your priority list—it’s a foundation for thriving in all areas of life!
• Pay attention to how you feel and make adjustments as needed—rest when you’re tired and move when you’re restless.

On January 21, 2025, Dr. Annetta Davenport, a Certified Employee Assistance Professional and Florida Licensed Mental Health Counselor, led an engaging 15-minute webinar designed to help participants restore balance and boost their overall wellbeing. This dynamic session, titled Reset Your Energy, offered practical insights into the importance of mental wellbeing, actionable strategies to improve outlook and simple techniques to rediscover positivity in daily life.

Whether you joined us live or are catching up now, this recap will highlight key takeaways from the session, empowering you to regain focus and approach each day with renewed energy and a positive mindset. Let’s dive into how small changes can lead to big transformations!

What is mental wellbeing and why does it matter?

Mental wellbeing is our sense of being present at any moment and is essential for thriving, not just surviving. Thriving supports growth, allowing us to expand our potential, adapt to change and live a meaningful life. Positive feelings like happiness, contentment and hope help us flourish, even when circumstances are challenging. Experts identify three components of mental wellbeing: emotional (our feelings and ability to manage them), psychological (values, sense of self and cognitive functioning), and social (our connections, relationships and sense of belonging). To nurture wellbeing, we can focus on nutrition, quality sleep and mental stimulation to support brain health while choosing positive approaches to challenges.

What are some ways to improve mental wellbeing and build resilience?

To enhance mental wellbeing, it is important to create a plan tailored to you. Start by monitoring your emotions, identifying patterns over time and expanding your emotional vocabulary to better understand your feelings. Next, prioritize regular social engagement—whether one-on-one or in groups—and focus on meaningful interactions by asking open-ended questions to deepen connections. Finally, support brain health through physical activities, mental exercises like puzzles or memory games and other practices that strengthen cognitive functioning. A deliberate approach to emotional awareness, social connection and mental stimulation can foster a balanced and thriving sense of well-being.

As we start a new year, many of us may feel the post-holiday slump or the “winter blues.” What are some simple strategies and techniques to help boost productivity and recharge during this time?

To combat the post-holiday slump or winter blues, one effective technique is using “I statements” to express emotions constructively. For example, saying, “I feel sad about missing the recital, but could you videotape it for me?” shares feelings, identifies their cause and invites social connection for support. Another approach is to focus on what’s working rather than dwelling on challenges. Redirect your energy to solutions and maintain a positive outlook by appreciating the resources and opportunities you already have. By shifting your mindset and engaging others, you can stay motivated and resilient.

What do you do when your natural disposition is that the glass is half empty?

If you tend to see the glass as half empty, forcing positivity isn’t the answer. Instead, start by acknowledging that your feelings are valid – it’s perfectly okay not to be naturally optimistic. Consider working with a counselor who can help you explore these feelings and develop strategies that feel authentic to you. A counselor can help you build skills to manage negative thoughts without pretending they do not exist. Small steps, like simply noticing one neutral thing each day (not even positive, just neutral), can be more helpful than trying to flip a switch to positivity. The goal is not to become a different person or to suddenly become optimistic – it is to develop tools that work for you while honoring who you are.

If you missed the Magellan Minute, listen to the recording here.

Spotlight Magellan allows coworkers to get to know one another by going beyond the surface level through facilitated discussions that delve into personal interests, experiences and aspirations. Through intentional engagement, Spotlight Magellan aims to cultivate a sense of community and camaraderie across our company, ultimately contributing to a more cohesive and fulfilling remote workplace culture.

This month, we’re getting to know Dr. Samuel Pullen, chief medical officer for the Idaho Behavioral Health Plan. Dr. Pullen has been with Magellan since April 2024.

Continue reading to learn more about Dr. Pullen:

Describe a typical workday in your life.

We have such a tremendous opportunity here in Idaho to improve access to high quality mental health and substance use treatment and services. I feel fortunate to have such great colleagues and because of the scope of the work, no day really feels typical. There are activities I routinely participate in to support and advanceour work. I participate in utilization management rounds and residential care rounds. Residential care rounds are led by me where initial and concurrent cases are presented for children being considered for residential care. This has been a topic of particular importance in Idaho over the last several years. I also work closely with our quality team, along with our Medical Director, Dr. Jonathan Harland. Together, we review critical incidents and cases where there might be a quality-of-care concern. I spend the rest of a typical day meeting with our clinical team during our morning huddles, meeting with providers addressing various issues, meeting with the state and working with other members of our senior leadership to ensure the successful implementation of the Idaho Behavioral Health Plan.

What are you currently reading?

I am currently reading A Brief History of Time by Stephen Hawking. I also recently finished reading Fevers, Feuds and Diamonds by Dr. Paul Farmer.

Do you have a favorite recipe you love to make (or have made for you)?

I have sweet tooth, and my kids have really gotten into baking. I am usually asking them to save me some cookie dough.

What is the farthest place you’ve traveled (or would like to travel to one day)?

Greece! My wife and I vacationed in Athens, Santorini and Mykonos. I would love to go to Africa one day and spend some time in Rwanda, Tanzania and Kenya.

Who (dead or alive) inspires you and why?

Dr. Paul Farmer was (and still is) someone who inspired me. If you’ve ever watched the documentary Bending the Arc or read any of his books, it’s very hard not to come away inspired and also a feeling that we have an obligation to challenge the status quo and take action where we see a need.

Catch up on previous Spotlight Magellan articles to get to know your Magellan colleagues! Read all articles here.

With the start of a new year, it helps to assess not only your physical health but your mental wellbeing, too. Mental wellbeing serves as a foundation for all your activities, and it is important to get your thoughts and emotions pointed in a positive direction.

• Check in with yourself. If the recent holidays have left you feeling mentally conflicted or rattled, confide in a supportive loved one or a mental health professional. You are not alone!
• Get a gratitude start. While it is easier to spot the negative aspects of life, do not forget to make note of the great gifts you have each day—health, family, friendships, purpose, appreciation of nature and more.
• Ramp up self-care, particularly during stressful times. To unplug from stress, decrease your screen time, get outdoor exercise and spend time with loved ones.
• Take a trip. The bleak midwinter can sometimes be a drag. So, schedule a long weekend away where you take in new sights and sounds. This refreshment is great for your mental wellbeing!

Emotional wellbeing: Managing your emotions.

Your ability to handle daily life and major life events is heavily influenced by your emotional wellbeing. Thus, it is important to find ways to keep your emotions on as even a keel as possible. When confronted with uncertainty, know that you have been resilient before and can use the tools of resilience again to minimize your levels of stress and anxiety.

Visit MagellanHealthcare.com/about/bh-resources/mymh or call your program for confidential mental
health resources.