LaPoint Shannon C, Simmons Grace Lee, Heinly Julia, Delgado Daylin, Shepherd Whitney S, Brookman-Frazee Lauren, Storch Eric A, Maddox Brenna B
TEACCH Autism Program, University of North Carolina at Chapel Hill, USA.
Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, USA.
Res Autism Spectr Disord. 2024 Sep;117. doi: 10.1016/j.rasd.2024.102450. Epub 2024 Jul 6.
Autistic youth experience high rates of anxiety, which has been treated with modified cognitive-behavioral therapy (CBT), often integrating exposure therapy. Such anxiety treatments are effective for this population; however, there remains a gap between these evidence-based mental health interventions and their implementation in community mental health (CMH) services where autistic youth receive care.
This qualitative study conducted semi-structured interviews with four types of community members in the United States: 15 autistic youth with anxiety, 15 caregivers of autistic youth with anxiety, 11 CMH clinicians, and 8 CMH clinic leaders. Participants identified the training needs of CMH clinicians to support the delivery of CBT for autistic youth with anxiety.
Through inductive thematic analysis, three themes were found: presentation of autism and anxiety, intervention delivery, and training format. Participants highlighted the need for clinician education to understand the varying presentations of autism and co-occurring anxiety and how to effectively deliver a personalized mental health intervention for autistic youth. Clinicians also desired a clinician training program that includes engaging components and offers individualized, ongoing support while the intervention is delivered.
Findings from this study will inform the development of a clinician training program to deliver CBT modified for autistic youth with anxiety in CMH contexts.
自闭症青少年焦虑症发病率很高，已采用改良认知行为疗法（CBT）进行治疗，该疗法常融入暴露疗法。此类焦虑症治疗方法对这一群体有效；然而，在自闭症青少年接受治疗的社区心理健康（CMH）服务中，这些循证心理健康干预措施与其实施之间仍存在差距。
这项定性研究对美国四类社区成员进行了半结构化访谈：15名患有焦虑症的自闭症青少年、15名患有焦虑症的自闭症青少年的照顾者、11名社区心理健康临床医生和8名社区心理健康诊所负责人。参与者确定了社区心理健康临床医生为支持对患有焦虑症的自闭症青少年提供认知行为疗法所需的培训需求。
通过归纳主题分析，发现了三个主题：自闭症和焦虑症的表现、干预措施的实施以及培训形式。参与者强调临床医生需要接受教育，以了解自闭症和并发焦虑症的不同表现，以及如何为自闭症青少年有效地提供个性化心理健康干预措施。临床医生还希望有一个临床医生培训项目，该项目包含引人入胜的内容，并在实施干预措施时提供个性化的持续支持。
本研究结果将为制定一个临床医生培训项目提供参考，以便在社区心理健康环境中为患有焦虑症的自闭症青少年提供改良的认知行为疗法。
