Westerberg Britta, Bäärnhielm Sofie, Giles Clover, Hylén Ulrika, Holländare Fredrik, Bejerot Susanne
University Health Care Research Center, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
Center for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm Health Care Services, Stockholm, Sweden.
Front Psychiatry. 2021 Dec 22;12:789663. doi: 10.3389/fpsyt.2021.789663. eCollection 2021.
Adults with autism spectrum disorder face several barriers to accessing evidence-based care, including difficulties in communicating needs, social anxiety or in traveling to a health care unit. In recent years, several forms of internet-based treatments have shown to be effective for a variety of psychiatric conditions. Internet-based treatment alternatives allow convenient and flexible formats, and therefore have the potential to increase access to health care for individuals with autism spectrum disorder. However, knowledge about how internet-based treatment features may suit the needs of individuals with autism is limited. The aim of this study was to explore the participant experiences of an internet-based intervention for adults with autism spectrum disorder. The primary focus of the investigation was on autism-specific needs in relation to the features unique to the online format. In this qualitative study, semi-structured telephone interviews were conducted with 14 participants who had completed a text-based internet-based intervention for adults with autism spectrum disorder. We used an inductive approach and analyzed the data using qualitative content analysis. Five main categories were identified: (1) implications of the online format, (2) the fixed non-individualized model, (3) therapist interaction, (4) interacting with other participants, and (5) making use of the treatment content. Overall, participants appreciated the availability and that they could work on their treatment independent of time or location. Among those participating in group-based chat-sessions with the other participants, it was considered a generally positive experience. Furthermore, most participants felt safe and relaxed in relation to the therapist and appreciated the text-based format. However, several participants felt that the format and content of the treatment was not sufficiently adapted to their individual life situation. In conclusion, this internet-based treatment constitutes an accessible and energy-saving treatment alternative for adults with autism. Further, integrating group-based components seems feasible in an otherwise individual internet-based treatment for individuals with autism. However, group-based components do require a clear purpose and rationale. Future studies should develop and evaluate treatment adaptations tailored to individual needs.
患有自闭症谱系障碍的成年人在获得循证护理方面面临诸多障碍，包括沟通需求困难、社交焦虑或前往医疗机构就诊不便等。近年来，几种基于互联网的治疗方法已被证明对多种精神疾病有效。基于互联网的治疗方式提供了便捷灵活的形式，因此有可能增加自闭症谱系障碍患者获得医疗服务的机会。然而，关于基于互联网的治疗特点如何满足自闭症患者需求的知识却很有限。本研究的目的是探索针对自闭症谱系障碍成年人的基于互联网干预措施的参与者体验。调查的主要重点是与在线形式独特特征相关的自闭症特定需求。在这项定性研究中，对14名完成了针对自闭症谱系障碍成年人的基于文本的互联网干预的参与者进行了半结构化电话访谈。我们采用归纳法，使用定性内容分析法对数据进行分析。确定了五个主要类别：（1）在线形式的影响，（2）固定的非个性化模式，（3）治疗师互动，（4）与其他参与者互动，以及（5）利用治疗内容。总体而言，参与者赞赏这种可获得性，并且他们可以不受时间或地点限制地进行治疗。在与其他参与者一起参加基于小组的聊天会话的人中，这被认为是一次总体上积极的经历。此外，大多数参与者在与治疗师的关系中感到安全和放松，并赞赏基于文本的形式。然而，一些参与者认为治疗的形式和内容没有充分适应他们的个人生活状况。总之，这种基于互联网的治疗方法为患有自闭症的成年人提供了一种可及且节能的治疗选择。此外，在针对自闭症患者的其他基于个体的互联网治疗中整合基于小组的组件似乎是可行的。然而，基于小组的组件确实需要明确的目的和理由。未来的研究应该开发并评估针对个体需求的治疗适应性。
