Improving talking therapies for autistic people

Background: Autistic people are more likely to experience common mental health conditions such as anxiety and depression. Whilst there is a substantial evidence base for psychological therapies for anxiety and depression and well established NHS Talking Therapies services, there is limited evidence on what works best for autistic people in this context. In particular, there is limited guidance on what adjustments and adaptations may work best for autistic people accessing psychological therapies services. Many autistic adults will have received a diagnosis recently and other people will be waiting for an assessment so will have added uncertainty about how what may help them to access services effectively. In this project, we aimed to understand the experience of autistic people (and those waiting for an autism assessment) when accessing Talking Therapies and improve the offer to autistic people through service redesign and training with clinicians. Methods: We used mixed methods in the project including qualitative analysis of semi-structured interviews with autistic people and clinicians in Talking Therapies services and quantitative analysis of Talking Therapies training needs and evaluation of the impact of training and service redesign. Results and Findings: We identified a number of themes from our interviews with autistic people and clinicians which has helped us to better understand the challenges to supporting autistic people in Talking Therapies. Both autistic people and clinicians reported that Talking Therapies services need significant adaptation (including clinician training) in order to meet the needs of autistic people. We designed training which clinicians reported had a positive effect. We also made changes to a Talking Therapies service to how they identified autistic people who accessed their service which led to approximately 5% of clients being identified as autistic (or having similar needs that require adaptations to therapies). Next steps: We will work to develop a large-scale research funding proposal to NIHR to build on this work and help evaluate the usefulness of these service changes particularly the impact they have upon autistic people’s experience of Talking Therapies. As part of this research and wider service development, the protocol for identifying autistic people could be tested in a wider number of Talking Therapies services and the training programme could be used in other services (following further refinement and depending on resources)