The experience of autistic adults accessing adapted cognitive behaviour therapy: ADEPT (Autism Depression Trial) qualitative evaluation

Jeremy P Horwood, Kate Cooper, Hannah Harvey , Lauren Davies, Ailsa Russell*

*Corresponding author for this work

Research output: Contribution to journalArticle (Academic Journal)peer-review

Abstract

Background
High rates of depression are frequently reported in autistic adults. There have been no randomised trials investigating low-intensity psychological interventions for mild-moderate depression adapted for autistic adults.

Method
This qualitative evaluation investigated the acceptability of the ADEPT pilot randomised controlled trial (RCT) design and guided self-help intervention. Participants (autistic adults with a diagnosis of depression (PHQ-9 score ≥ 10)) were randomised to Guided Self-Help (GSH): low intensity psychological intervention based on Behavioural Activation adapted for autistic adults, or Treatment as Usual (TAU). 21 trial participants (14 GSH and 7 TAU), and 5 low intensity psychological therapists or ‘coaches’ were interviewed, and transcripts analysed thematically.

Results
All participants and coaches welcomed an intervention for depression adapted for autistic adults due to current lack of provision in mainstream services. Interviews highlighted participants' preference for GSH over TAU. Dissatisfaction with prior experience of TAU was identified as a potential driver for differential attrition from the TAU arm. Participants who received GSH appreciated the coaches having a good understanding of autistic adults and were positive towards the aim and structure of the GSH intervention. Suggested improvements include more regularly checking progress with therapy goals.

Conclusions
A full scale RCT to evaluate the effectiveness of this intervention is now warranted. Future trial study design needs to address potential for differential rate of participant recruitment and attrition between the treatment and comparison groups due to negative prior experience of TAU.
Original languageEnglish
Article number101802
Number of pages10
JournalResearch in Autism Spectrum Disorders
Volume86
Early online date25 May 2021
DOIs
Publication statusPublished - 1 Aug 2021

Bibliographical note

Funding Information:
This study was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme (HTA 14/43/02). This study was also supported by the NIHR Bristol Biomedical Research Centre (BRC-1215-2011). This study was designed and delivered in collaboration with the Bristol Randomised Trials Collaboration (BRTC) a UKCRC Registered Clinical Trials Unit (CTU) which, as part of the Bristol Trials Centre, is in receipt of NIHR CTU support funding.

Funding Information:
This study was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme (HTA 14/43/02). This study was also supported by the NIHR Bristol Biomedical Research Centre (BRC-1215-2011). This study was designed and delivered in collaboration with the Bristol Randomised Trials Collaboration (BRTC) a UKCRC Registered Clinical Trials Unit (CTU) which, as part of the Bristol Trials Centre, is in receipt of NIHR CTU support funding.

Publisher Copyright:
© 2021

Structured keywords

  • ADEPT
  • BRTC

Keywords

  • Autism spectrum disorders
  • Adults
  • Qualitative research
  • Depression
  • Cognitive behaviour therapy

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