Seeking advice advocating for an adult ASD screening
TL;DR at bottom.
I (F/33) and several people close to me have suspected that I may have ASD Level 1. As of last year, I met with a Kaiser-provided LCSW (referred by my PCP), and I have a second appointment tomorrow. After the first appointment, I was disappointed that I didn't entirely feel heard as the LCSW mainly appeared to want to funnel me towards the route of medication.
In this next appointment, I want to advocate more vocally than in my last meeting for an ASD screening because I’m looking for better understanding, more self-compassion, and support/resources for challenges I’ve experienced long-term (interviews, social interactions, executive functioning, overwhelm, etc.).
For context, I don’t have any prior mental health diagnoses or medication history. I’ve been in therapy on and off for about 10 years, but I grew up in a household where mental health concerns were dismissed, so there was never any evaluation or documentation when I was younger. Also, I was homeschooled within the US until the 9th grade, so it’s not like any primary school teachers could ever bring concerns to my parents.
From what I understand, the Kaiser LCSW wouldn’t diagnose ASD directly but would refer me for further evaluation if appropriate. I’ve also heard mixed things—that some adults are asked to attend multiple LCSW sessions first (most commonly I've seen three), and that adult ASD assessment can be difficult to access, especially without childhood documentation.
At our last meeting, the LCSW suggested anxiety and referred me to Psychiatry for medication, as well as two classes:
• Living with Anxiety (I enrolled)
• Navigating Adult ADHD (I didn’t enroll because of timing)
At this point, I’m not interested in medication yet. I’d prefer to better understand what may be underlying my experiences before treating symptoms alone. I’m open to discussing medication later if it makes sense.
TL;DR: What advice do you have for advocating for an ASD screening with an LCSW? How can I communicate my concerns clearly without coming across as resistant or non-compliant to treatment and medication if they disagree with me?
UPDATE: after talking with the LCSW, I learned that from our last appointment a year ago, she had made an anxiety diagnosis but not a diagnosis for ADHD as that would have needed more extensive screening and a treatment plan. She had only ever generally screened for ADHD.
Today, she screened me for ASD and ADHD and I scored high enough for ASD that she is referring me to a Kaiser therapist who will be able to make the referral for further evaluation. She clarified that Kaiser has a very conservative definition for Adults with ASD and that Kaiser needs to see there has been severe impact to one’s life before referring for the evaluation. Based off the things her and I talked about, she said she finds it reasonable and with good cause that the therapist will refer me for the evaluation.
Thank you to everyone who answered. I cross-posted this to other communities, but this is the only one that received input and I’m grateful.