Top

Journal of Autism and Developmental Disorders

Gepubliceerd in:

19-10-2023 | Original Paper

Mental Health Providers’ Perspectives on What Helps and Hinders in Psychotherapy for Autistic Adults with Co-occurring Mental Health Problems

Auteurs: Theresa Jubenville-Wood, David B. Nicholas, Jonathan Weiss, Sharon Cairns

Gepubliceerd in: Journal of Autism and Developmental Disorders | Uitgave 11/2024

Abstract

Autistic adults experience disproportionate rates of co-occurring mental health problems. Psychotherapy has been recognized as an appropriate treatment approach, but evidence is limited. Researchers used a qualitative research paradigm to explore the experiences of mental health providers who provide psychotherapy to autistic adults. The Enhanced Critical Incident Technique was used to interview 13 mental health providers regarding perceptions of facilitating therapy with autistic adults. This research highlights challenges to providing psychotherapy to autistic adults while also illuminating ways that mental health providers have worked to ameliorate such challenges and create positive experiences in therapy. This research also contrasts therapy for autistic adults relative to the general population. Practice recommendations and suggestions for future research are offered.

vorige artikel Intestinal Symptoms Among Children aged 2–7 Years with Autism Spectrum Disorder in 13 Cities of China

volgende artikel Action-outcome Regularity Perceptual Sensitivity in Children with Developmental Coordination Disorder

We recognize that there is no consensus regarding how to communicate about autism. In this paper, we use identity-first language (e.g., “autistic person/adult”). More recently, members of the autism community have indicated a preference for identity-first language over person-first language (e.g., “person with autism”), and authors have highlighted issues associated with using person-first language (Bottema-Beutel et al., 2020; Kenny et al., 2016). Identity-first language is intended to affirm and validate the autistic identity.

Ackerman, S. J., & Hilsenroth, M. J. (2003). A review of therapist characteristics and techniques positively impacting the therapeutic alliance. Clinical Psychology Review, 23, 1–33. https://doi.org/10.1016/S0272-7358(02)00146-0CrossRefPubMed

American Psychological Association. (2006). Evidence-based practice in psychology. American Psychologist, 61(4), 271–285. https://doi.org/10.1037/0003-066X.61.4.271CrossRef

Anderson, S., & Morris, J. (2006). Cognitive behaviour therapy for people with Asperger syndrome. Behavioural and Cognitive Psychotherapy, 34(3), 293–303. https://doi.org/10.1017/S1352465805002651CrossRef

Attwood, T. (2015). The complete guide to Asperger’s syndrome. Jessica Kingsley.

Barkham, M., & Mellor-Clark, J. (2003). Bridging evidence-based practice and practice-based evidence: Psychological therapies. Clinical Psychology and Psychotherapy, 10, 319–327. https://doi.org/10.1002/cpp.379CrossRef

Binnie, J., & Blainey, S. (2013). The use of cognitive behavioural therapy for adults with autism spectrum disorders: A review of the evidence. Mental Health Review Journal, 18(2), 93–104. https://doi.org/10.1108/MHRJ-05-2013-0017CrossRef

Bottema-Beutel, K., Kapp, S. K., Lester, J. N., Sasson, N. J., & Hand, B. N. (2020). Avoiding ableist language: Suggestions for autism researchers. Autism in Adulthood, 3(1), 18–29. https://doi.org/10.1089/aut.2020.0014CrossRef

Brookman-Frazee, L. I., Drahota, A., & Stadnick, N. (2012a). Training community mental health therapists to deliver a package of evidence-based practice strategies for school-age children with autism spectrum disorders: A pilot study. Journal of Autism and Developmental Disorders, 42(8), 1651–1661. https://doi.org/10.1007/s10803-011-1406-7CrossRefPubMedPubMedCentral

Brookman-Frazee, L. I., Drahota, A., Stadnick, N., & Palinkas, L. A. (2012b). Therapist perspectives on community mental health services for children with autism spectrum disorders. Administration and Policy in Mental Health and Mental Health Services Research, 39(5), 365–373. https://doi.org/10.1007/s10488-011-0355-yCrossRefPubMed

Butterfield, L. D., Borgen, W. A., Amundson, N. E., & Maglio, A. S. T. (2005). Fifty years of the critical incident technique: 1954–2004 and beyond. Qualitative Research, 5(4), 475–497. https://doi.org/10.1177/1468794105056924CrossRef

Butterfield, L. D., Borgen, W. A., Maglio, A. S. T., & Amundson, N. E. (2009). Using the enhanced critical incident technique in counselling psychology research. Canadian Journal of Counselling, 43(4), 265–282.

Cachia, R. L., Anderson, A., & Moore, D. W. (2016). Mindfulness in individuals with autism spectrum disorder: A systematic review and narrative analysis. Review Journal of Autism and Developmental Disorders, 3(2), 165–178. https://doi.org/10.1007/s40489-016-0074-0CrossRef

Camm-Crosbie, L., Bradley, L., Shaw, R., Baron-Cohen, S., & Cassidy, S. (2019). ‘People like me don’t get support’: Autistic adults’ experiences of support and treatment for mental health difficulties, self-injury and suicidality. Autism, 23(6), 1431–1441. https://doi.org/10.1177/1362361318816053CrossRefPubMed

Canadian Mental Health Association. (2018). Psychotherapy. https://cmha.ca/documents/psychotherapy

Canadian Psychological Association. (2012). Evidence-based practice of psychological treatments: A Canadian perspective. http://www.cpa.ca/docs/File/Practice/Report_of_the_EBP_Task_Force_FINAL_Board_Approved_2012.pdf

Christon, L. M., Arnold, C. C., & Myers, B. J. (2015). Professionals’ reported provision and recommendation of psychosocial interventions for youth with autism spectrum disorder. Behavior Therapy, 46(1), 68–82. https://doi.org/10.1016/j.beth.2014.02.002CrossRefPubMed

Conner, C. M., & White, S. W. (2018). Brief report: Feasibility and preliminary efficacy of individual mindfulness therapy for adults with autism spectrum disorder. Journal of Autism and Developmental Disorders, 48(1), 290–300. https://doi.org/10.1007/s10803-017-3312-0CrossRefPubMed

Cooper, C. M., Rosen, T., Kim, H., Eaton, N. R., Cohn, E., Drahota, A., & Kerns, C. M. (2023). Predictors of expert providers’ familiarity with intervention practices for school-and transition-age youth with autism spectrum disorder. Autism, 27(2), 331–343. https://doi.org/10.1177/13623613221100787CrossRefPubMed

Cooper, K., Loades, M. E., & Russell, A. J. (2018). Adapting psychological therapies for autism- Therapist experience, skills and confidence. Research in Autism Spectrum Disorders, 45, 43–50. https://doi.org/10.1016/j.rasd.2017.11.002CrossRefPubMed

Corbett, B. A., Schupp, C. W., Levine, S., & Mendoza, S. (2009). Comparing cortisol, stress, and sensory sensitivity in children with autism. Autism Research, 2(1), 39–49. https://doi.org/10.1002/aur.64CrossRefPubMed

Crane, L., Adams, F., Harper, G., Welch, J., & Pellicano, E. (2019a). ‘Something needs to change’: Mental health experiences of young autistic adults in England. Autism, 23(2), 477–493. https://doi.org/10.1177/1362361318757048CrossRefPubMed

Crane, L., Davidson, I., Prosser, R., & Pellicano, E. (2019b). Understanding psychiatrists’ knowledge, attitudes and experiences in identifying and supporting their patients on the autism spectrum: Online survey. Bjpsych Open, 5(3), 1–8. https://doi.org/10.1192/bjo.2019.12CrossRef

Crenshaw, K. (1991). Mapping the margins: Intersectionality, identity politics, and violence against women of color. Stanford Law Review, 43(6), 1241–1299. https://doi.org/10.2307/1229039CrossRef

Croen, L. A., Zerbo, O., Qian, Y., Massolo, M. L., Rich, S., Sidney, S., & Kripke, C. (2015). The health status of adults on the autism spectrum. Autism, 19(7), 814–823. https://doi.org/10.1177/1362361315577517CrossRefPubMed

Dyson, M. W., Chlebowski, C., & Brookman-Frazee, L. (2019). Therapists’ adaptations to an intervention to reduce challenging behaviors in children with autism spectrum disorder in publicly funded mental health services. Journal of Autism and Developmental Disorders, 49(3), 924–934. https://doi.org/10.1007/s10803-018-3795-3CrossRefPubMed

Flanagan, J. C. (1954). The critical incident technique. Psychological Bulletin, 51(4), 327–358. https://doi.org/10.1037/h0061470CrossRefPubMed

Gaus, V. L. (2011). Adult Asperger syndrome and the utility of cognitive-behavioral therapy. Journal of Contemporary Psychotherapy, 41(1), 47–56. https://doi.org/10.1007/s10879-010-9159-8CrossRef

Gillberg, I. C., Helles, A., Billstedt, E., & Gillberg, C. (2016). Boys with Asperger syndrome grow up: Psychiatric and neurodevelopmental disorders 20 years after initial diagnosis. Journal of Autism and Developmental Disorders, 46(1), 74–82. https://doi.org/10.1007/s10803-015-2544-0CrossRefPubMed

Gillott, A., & Standen, P. J. (2007). Levels of anxiety and sources of stress in adults with autism. Journal of Intellectual Disabilities, 11(4), 359–370. https://doi.org/10.1177/1744629507083585CrossRefPubMed

Hill, E. L. (2004). Evaluating the theory of executive dysfunction in autism. Developmental Review, 24(2), 189–233. https://doi.org/10.1016/j.dr.2004.01.001CrossRef

Horvath, A. O., Del Re, A. C., Flückiger, C., & Symonds, D. (2011). Alliance in individual psychotherapy. Psychotherapy, 48(1), 9–16. https://doi.org/10.1037/a0022186CrossRefPubMed

Horvath, A. O., & Symonds, B. D. (1991). Relation between working alliance and outcome in psychotherapy: A meta-analysis. Journal of Counseling Psychology, 38(2), 139–149. https://doi.org/10.1037/0022-0167.38.2.139CrossRef

Joshi, G., Wozniak, J., Petty, C., Martelon, M. K., Fried, R., Bolfek, A., Kotte, A., Stevens, J., Furtak, S. L., Bourgeois, M., Caruso, J., Caron, A., & Biederman, J. (2013). Psychiatric comorbidity and functioning in a clinically referred population of adults with autism spectrum disorders: A comparative study. Journal of Autism and Developmental Disorders, 43(6), 1314–1325. https://doi.org/10.1007/s10803-012-1679-5CrossRefPubMed

Kain, D. L. (2004). Owning significance: the critical incident technique in research. In K. DeMarris & S. Lapan (Eds.), Foundations for research: Methods of inquiry in education and the social sciences (pp. 69–86). Lawrence Erlbaum.

Kenny, L., Hattersley, C., Molins, B., Buckley, C., Povey, C., & Pellicano, E. (2016). Which terms should be used to describe autism? Perspectives from the UK autism community. Autism, 20(4), 442–462. https://doi.org/10.1177/1362361315588200CrossRefPubMed

Kerns, C. M., Moskowitz, L. J., Rosen, T., Drahota, A., Wainer, A., Josephson, A. R., & Lerner, M. D. (2019). A multisite, multidisciplinary Delphi consensus study describing “usual care” intervention strategies for school-age to transition-age youth with autism. Journal of Clinical Child & Adolescent Psychology, 48(1), S247–S268. https://doi.org/10.1080/15374416.2017.1410826CrossRef

Kerns, C. M., Newschaffer, C. J., & Berkowitz, S. J. (2015). Traumatic childhood events and autism spectrum disorder. Journal of Autism and Developmental Disorders, 45(11), 3475–3486. https://doi.org/10.1007/s10803-015-2392-yCrossRefPubMed

Kiep, M., Spek, A. A., & Hoeben, L. (2015). Mindfulness-based therapy in adults with an autism spectrum disorder: Do treatment effects last? Mindfulness, 6(3), 637–644. https://doi.org/10.1007/s12671-014-0299-xCrossRef

Lai, M. C., Kassee, C., Besney, R., Bonato, S., Hull, L., Mandy, W., Szatmari, P., & Ameis, S. H. (2019). Prevalence of co-occurring mental health diagnoses in the autism population: A systematic review and meta-analysis. The Lancet Psychiatry, 6(10), 819–829. https://doi.org/10.1016/S2215-0366(19)30289-5CrossRefPubMed

Lerner, M. D., Brown, C. E., Sridhar, A., Tschida, J. E., Felsman, P., Libsack, E. J., Kerns, C. M., Moskowitz, L. J., Soorya, L., Wainer, A., Cohn, E., & Drahota, A. (2022). Usual care for youth with autism spectrum disorder: Community-based providers’ reported familiarity with treatment practices. Frontiers in Psychiatry. https://doi.org/10.3389/fpsyt.2022.923025CrossRefPubMed

Lipinski, S., Blanke, E. S., Suenkel, U., & Dziobek, I. (2019). Outpatient psychotherapy for adults with high-functioning autism spectrum condition: Utilization, treatment satisfaction, and preferred modifications. Journal of Autism and Developmental Disorders, 49(3), 1154–1168. https://doi.org/10.1007/s10803-018-3797-1CrossRefPubMed

Lopez, B. R., Lincoln, A. J., Ozonoff, S., & Lai, Z. (2005). Examining the relationship between executive functions and restricted, repetitive symptoms of autistic disorder. Journal of Autism and Developmental Disorders, 35(4), 445–460. https://doi.org/10.1007/s10803-005-5035-xCrossRefPubMed

Maddox, B. B., Crabbe, S., Beidas, R. S., Brookman-Frazee, L., Cannuscio, C. C., Miller, J. S., Nicolaidis, C., & Mandell, D. S. (2019). “I wouldn’t know where to start”: Perspectives from clinicians, agency leaders, and autistic adults on improving community mental health services for autistic adults. Autism. https://doi.org/10.1177/1362361319882227CrossRefPubMed

Maddox, B. B., & Gaus, V. L. (2019). Community mental health services for autistic adults: Good news and bad news. Autism Adulthood, 1(1), 15–19. https://doi.org/10.1089/aut.2018.0006CrossRefPubMed

Maïano, C., Normand, C. L., Salvas, M., Moullec, G., & Aimé, A. (2015). Prevalence of school bullying among youth with autism spectrum disorders: A systematic review and meta‐analysis. Autism Research, 9(6), 601–615. https://doi.org/10.1002/aur.1568CrossRefPubMed

National Institute for Health and Care Excellence. (2012). Autism spectrum disorder in adults: Diagnosis and management (clinical guideline [CG142]). https://www.nice.org.uk/guidance/cg142/chapter/Introduction

Nicolaidis, C., Raymaker, D. M., Ashkenazy, E., McDonald, K. E., Dern, S., Baggs, A. E. V., Kapp, S. K., Weiner, M., & Boisclair, W. C. (2015). “Respect the way I need to communicate with you”: Healthcare experiences of adults on the autism spectrum. Autism, 19(7), 824–831. https://doi.org/10.1177/1362361315576221CrossRefPubMed

Saxe, A. (2017). The theory of intersectionality: A new lens for understanding the barriers faced by autistic women. Canadian Journal of Disability Studies, 6(4), 153–178. https://doi.org/10.15353/cjds.v6i4.386CrossRef

Schendel, D. E., Overgaard, M., Christensen, J., Hjort, L., Jørgensen, M., Vestergaard, M., & Parner, E. T. (2016). Association of psychiatric and neurologic comorbidity with mortality among persons with autism spectrum disorder in a Danish population. JAMA Pediatrics, 170(3), 243–250. https://doi.org/10.1001/jamapediatrics.2015.3935CrossRefPubMed

Seligman, M. E., & Csikszentmihalyi, M. (2000). Positive psychology. An Introduction. The American Psychologist, 55(1), 5–14. https://doi.org/10.1037/0003-066X.55.1.5CrossRefPubMed

Simonoff, E., Pickles, A., Charman, T., Chandler, S., Loucas, T., & Baird, G. (2008). Psychiatric disorders in children with autism spectrum disorders: Prevalence, comorbidity, and associated factors in a population-derived sample. Journal of the American Academy of Child and Adolescent Psychiatry, 47(8), 921–929. https://doi.org/10.1097/CHI.0b013e318179964fCrossRefPubMed

Spain, D., & Happé, F. (2019). How to optimise cognitive behaviour therapy (CBT) for people with autism spectrum disorders (ASD): A Delphi study. Journal of Rational—Emotive and Cognitive—Behavior Therapy, 38, 184–208. https://doi.org/10.1007/s10942-019-00335-1CrossRef

Spain, D., Sin, J., Chalder, T., Murphy, D., & Happé, F. (2015). Cognitive behaviour therapy for adults with autism spectrum disorders and psychiatric co-morbidity: A review. Research in Autism Spectrum Disorders, 9, 151–162. https://doi.org/10.1016/j.rasd.2014.10.019CrossRef

Spek, A. A., van Ham, N. C., & Nyklíček, I. (2013). Mindfulness-based therapy in adults with an autism spectrum disorder: A randomized controlled trial. Research in Developmental Disabilities, 34(1), 246–253. https://doi.org/10.1016/j.ridd.2012.08.009CrossRefPubMed

Walters, S., Loades, M., & Russell, A. (2016). A systematic review of effective modifications to cognitive behavioural therapy for young people with autism spectrum disorders. Review Journal of Autism and Developmental Disorders, 3(2), 137–153. https://doi.org/10.1007/s40489-016-0072-2CrossRef

Warfield, M. E., Crossman, M. K., Delahaye, J., Der Weerd, E., & Kuhlthau, K. A. (2015). Physician perspectives on providing primary medical care to adults with autism spectrum disorders (ASD). Journal of Autism and Developmental Disorders, 45(7), 2209–2217. https://doi.org/10.1007/s10803-015-2386-9CrossRefPubMed

Weiss, J. A., & Fardella, M. A. (2018). Victimization and perpetration experiences of adults with autism. Frontiers in Psychiatry, 9, 1–10. https://doi.org/10.3389/fpsyt.2018.00203CrossRef

Weiss, J. A., & Lunsky, Y. (2010). Group cognitive behaviour therapy for adults with Asperger syndrome and anxiety or mood disorder: A case series. Clinical Psychology and Psychotherapy, 17(5), 438–446. https://doi.org/10.1002/cpp.694CrossRefPubMed

Weiss, J. A., Lunsky, Y., & Morin, D. (2010). Psychology graduate student training in developmental disability: A Canadian survey. Canadian Psychology, 51(3), 177–184. https://doi.org/10.1037/a0019733CrossRef

Titel: Mental Health Providers’ Perspectives on What Helps and Hinders in Psychotherapy for Autistic Adults with Co-occurring Mental Health Problems
Auteurs: Theresa Jubenville-Wood
David B. Nicholas
Jonathan Weiss
Sharon Cairns
Publicatiedatum: 19-10-2023
Uitgeverij: Springer US
Gepubliceerd in: Journal of Autism and Developmental Disorders / Uitgave 11/2024
Print ISSN: 0162-3257
Elektronisch ISSN: 1573-3432
DOI: https://doi.org/10.1007/s10803-023-06143-y

Andere artikelen Uitgave 11/2024

School Experiences and Anxiety Trajectories Among Youth with Intellectual Disabilities

Original Article

A Pilot Randomised Control Trial Exploring the Feasibility and Acceptability of Delivering a Personalised Modular Psychological Intervention for Anxiety Experienced by Autistic Adults: Personalised Anxiety Treatment-Autism (PAT-A)

Open Access
Original Paper

Quality of Life Among Caregivers of Children with Autism Spectrum Disorder and Attention Deficit Hyperactivity Disorder: A Cross Sectional Study

Original Paper

Intellectual, Adaptive, and Behavioral Functioning Associated with Designated Levels of Support in a Sample of Autistic Children Referred for Tertiary Assessment

Original Paper

Efficacy of a Parent-Implemented Pivotal Response Treatment for Children with Autism Spectrum Disorder

Article

Do Types of Information in an Animated Video Intervention Affect University Students’ Autism Knowledge and Openness Towards Peers on the Autism Spectrum?

Original Paper