Gawronski A, Kuzmanovic B, Georgescu A, Kockler H, Lehnhardt F-G, Schilbach L, Volpert K, Vogeley K
Klinik und Poliklinik für Psychiatrie und Psychotherapie, Universitätsklinik Köln, Köln.
Fortschr Neurol Psychiatr. 2011 Nov;79(11):647-54. doi: 10.1055/s-0031-1281734. Epub 2011 Oct 17.
In recent years there has been a strong increase in psychiatric diagnoses belonging to the autism spectrum in adulthood. For this diagnostic group of patients, often characterised by normal or above-average intelligence, i.e, high-functioning autism or Asperger syndrome, only few adequate psychotherapeutic treatment options exist. In order to develop a disorder-specific psychotherapeutic group training in a demand-oriented manner, we surveyed adults with autism spectrum disorders (ASD) concerning their needs and expectations relating to psychotherapy.
A two-step analysis of needs was carried out: First, after a set of open questions written descriptions of 33 individuals with ASD were analysed using the qualitative content analysis according to Mayring. The resulting category system provided the basis for the closed questionnaire EPAS ("Expectations Psychotherapy Autism Spectrum"). In a second step, 64 individuals with ASD were assessed by EPAS to confirm the relevance of the qualitatively derived dimensions.
Both the results of the qualitative and the quantitative analysis confirmed the initial hypothesis that adults with ASD expressed problems associated with disorder-specific core symptoms. Moreover, the quantitative analysis demonstrated that in addition to deficits in social competence and identity formation, the lack of stress management skills represents a crucial load factor. Also, the therapist-associated variables were reported to play an important role for the patients.
The analysis of needs indicates that psychotherapy for adults with ASD should focus on the training and development of social-communicative skills. Furthermore, dealing with stress in everyday situations and identity formation after diagnosis should also be considered. Psychotherapists can refer to well-established techniques from cognitive behavioural therapy, which are known to be effective in the identified fields and should have sufficient disorder-specific knowledge, not least in order to prevent misunderstandings within the therapeutic working relationship.
近年来，成年期自闭症谱系中的精神疾病诊断数量大幅增加。对于这一诊断群体的患者，通常具有正常或高于平均水平的智力，即高功能自闭症或阿斯伯格综合征，目前仅有少数足够的心理治疗选择。为了以需求导向的方式开展针对特定疾病的心理治疗团体培训，我们对患有自闭症谱系障碍（ASD）的成年人进行了调查，了解他们对心理治疗的需求和期望。
进行了两步需求分析：首先，在一组开放性问题之后，使用根据迈林的定性内容分析法对33名患有ASD的个体的书面描述进行了分析。所得的类别系统为封闭式问卷EPAS（“自闭症谱系心理治疗期望”）提供了基础。第二步，通过EPAS对64名患有ASD的个体进行评估，以确认定性得出的维度的相关性。
定性和定量分析的结果均证实了最初的假设，即患有ASD的成年人表达了与特定疾病核心症状相关的问题。此外，定量分析表明，除了社交能力和身份形成方面的缺陷外，缺乏压力管理技能也是一个关键的负担因素。此外，据报告治疗师相关变量对患者也起着重要作用。
需求分析表明，针对患有ASD的成年人的心理治疗应侧重于社交沟通技能的培训和发展。此外，还应考虑应对日常压力和诊断后的身份形成。心理治疗师可以参考认知行为疗法中成熟的技术，这些技术在已确定的领域中被认为是有效的，并且应该具备足够的特定疾病知识，尤其是为了防止治疗工作关系中的误解。
