McVey Alana J, Glaves Katherine Jo, Seaver Samantha, Casagrande Karís A
Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, United States.
Autism Center, Seattle Children's Hospital, Seattle, WA, United States.
Front Psychiatry. 2023 Sep 25;14:1259025. doi: 10.3389/fpsyt.2023.1259025. eCollection 2023.
Autistic adolescents and adults commonly experience mental health concerns; however, mental health clinicians may hold implicit stigmatizing views of autism that contribute to case conceptualization and treatment goal setting that align more with caregivers' than clients' goals. This impingement on client autonomy is concerning, problematic, and potentially harmful for autistic clients who are of an age to set their own treatment agenda regardless of co-occurring intellectual disability and/or language delays. An application of the shared decision-making framework, an evidence-based tool for promoting client autonomy, can help to avoid these challenges in treatment. In this perspective, we use a case vignette as an anchor for discussing the imperative of honoring autistic clients' autonomy in mental health treatment and guiding shared decision-making to reduce stigma, promote autonomy, and increase collaborative care for autistic clients in mental health treatment.
患有自闭症的青少年和成年人通常会有心理健康方面的问题；然而，心理健康临床医生可能对自闭症持有隐性的污名化观点，这导致病例概念化和治疗目标设定更多地与照顾者而非患者自身的目标保持一致。这种对患者自主权的侵犯令人担忧、存在问题，并且对于那些无论是否同时存在智力残疾和/或语言发育迟缓都已到能够设定自己治疗议程年龄的自闭症患者来说，可能是有害的。应用共享决策框架这一促进患者自主权的循证工具，有助于避免治疗中的这些挑战。从这个角度出发，我们以一个病例 vignette 为切入点，讨论在心理健康治疗中尊重自闭症患者自主权的必要性，并指导共享决策，以减少污名化、促进自主权，并加强对心理健康治疗中自闭症患者的协同护理。 （注：原文中“vignette”不太明确具体准确释义，这里暂保留英文）
