Department of Human Services, University of Virginia, Charlottesville, Virginia, USA.
Clin Psychol Psychother. 2023 Jul-Aug;30(4):767-779. doi: 10.1002/cpp.2835. Epub 2023 Feb 3.
Autistic adults are at high risk for co-occurring mental health problems and need access to effective and appropriate mental health treatment. However, the relative effectiveness or acceptability of specific mental health strategies among autistic adults has not been previously examined. The current study sought to gain a deeper understanding of autistic adults' experiences and preferences regarding mental health strategies using a mixed methods approach. Autistic adults (n = 303, ages 21-77) completed online surveys and open-ended questions about their mental health and therapy experiences. Most (88.8%) had participated in therapy, with cognitive approaches being the most common. Regarding overall therapy experiences, qualitative analyses revealed four primary themes and nine subthemes. Therapist acceptance and understanding were seen as critical for therapy success, and many participants felt that therapy was helpful for personal growth. However, many participants found that talking in session was challenging and noted that aspects of the session format affected their ability to engage in therapy. Regarding specific strategies, four cross-cutting themes and eight strategy-specific subthemes were identified. A variety of strategies were seen as helpful for reducing anxiety and improving mood. However, autistic adults reported trouble generalizing strategies to daily life and found some techniques to be difficult to implement due, in part, to their unique autism-related needs. As the first study of its kind, the results underscore the importance of establishing a safe and accepting therapeutic relationship, providing accommodations to support communication needs, and considering individual differences and preferences when selecting mental health strategies for autistic clients.
自闭症成年人存在较高的共患心理健康问题风险，需要获得有效且适当的心理健康治疗。然而，自闭症成年人对特定心理健康策略的相对有效性或可接受性尚未得到先前的检验。本研究旨在采用混合方法来更深入地了解自闭症成年人对心理健康策略的体验和偏好。303 名年龄在 21-77 岁之间的自闭症成年人完成了关于他们心理健康和治疗体验的在线调查和开放式问题。大多数人（88.8%）参加过治疗，其中认知方法最为常见。关于整体治疗体验，定性分析揭示了四个主要主题和九个子主题。治疗师的接受和理解被视为治疗成功的关键，许多参与者认为治疗有助于个人成长。然而，许多参与者发现会话中交谈具有挑战性，并指出会话形式的某些方面影响了他们参与治疗的能力。关于具体策略，确定了四个交叉主题和八个策略特定的子主题。各种策略被认为有助于减轻焦虑和改善情绪。然而，自闭症成年人报告说难以将策略推广到日常生活中，并发现一些技术难以实施，部分原因是他们独特的自闭症相关需求。作为此类研究中的首例，研究结果强调了建立安全和接受的治疗关系、提供住宿以支持沟通需求以及在为自闭症患者选择心理健康策略时考虑个体差异和偏好的重要性。
