Community-guided, autism-adapted group cognitive behavioral therapy for depression in autistic youth (CBT-DAY): Preliminary feasibility, acceptability, and efficacy / Marissa C. ROTH ; Ann V. PATERSON ; Alexandra X. JACOBS ; Zachary J. WILLIAMS in Autism, 28-8 (August 2024)  

Public ISBD [article]  inAutism > 28-8 (August 2024) . - p.1902-1918 Titre : Community-guided, autism-adapted group cognitive behavioral therapy for depression in autistic youth (CBT-DAY): Preliminary feasibility, acceptability, and efficacy Type de document : texte imprimé Auteurs : Marissa C. ROTH, Auteur ; Ann V. PATERSON, Auteur ; Alexandra X. JACOBS, Auteur ; Zachary J. WILLIAMS, Auteur Article en page(s) : p.1902-1918 Langues : Anglais (eng) Mots-clés : autism  cognitive behavioral therapy  community-guided intervention  depression  harms monitoring  youth Index. décimale : PER Périodiques Résumé : This study examined the preliminary feasibility, acceptability, and efficacy of an autism-adapted cognitive behavioral therapy for depression in autistic youth, CBT-DAY. Twenty-four autistic youth (11-17 years old) participated in the pilot non-randomized trial including 5 cisgender females, 14 cisgender males, and 5 non-binary youth. Youth participated in 12 weeks of, CBT-DAY and youth depressive symptoms (i.e., primary clinical outcome) and emotional reactivity and self-esteem (i.e., intervention mechanisms) were assessed through self-report and caregiver report at four timepoints: baseline (week 0), midpoint (week 6), post-treatment (week 12), and follow-up (week 24). Results suggested that CBT-DAY may be feasible (16.67% attrition) in an outpatient setting and acceptable to adolescents and their caregivers. Bayesian linear mixed-effects models showed that CBT-DAY may be efficacious in targeting emotional reactivity [?T1-T3 = 2.53, CrI95% ( 4.62, 0.58), Pd = 0.995, d = 0.35] and self-esteem [?T1-T3 = 3.57, CrI95% ( 5.17, 2.00), Pd > 0.999, d = 0.47], as well as youth depressive symptom severity [? = 2.72, CrI95% ( 3.85, 1.63), Pd > 0.999]. Treatment gains were maintained at follow-up. A cognitive behavioral group therapy designed for and with autistic people demonstrates promise in targeting emotional reactivity and self-esteem to improve depressive symptom severity in youth. Findings can be leveraged to implement larger, more controlled trials of CBT-DAY. The trial was registered at Clinicaltrials.gov (Identifier: NCT05430022; https://beta.clinicaltrials.gov/study/NCT05430022). Lay Abstract Depression in youth is a significant public health problem worldwide, particularly for autistic youth who are over twice as likely to experience depression than their non-autistic peers. Although pathways to depression are complex, emotional reactivity and negative self-esteem are two risk factors for depression in autistic and non-autistic youth. Although autistic youth are more likely to experience depression than their non-autistic peers, psychotherapy options for autistic youth are very limited; community guidance in the development and testing of psychotherapy programs is a promising approach in autism. Therefore, in this study, we designed an autism-adapted CBT-DAY, in collaboration with autistic community members. Specifically, CBT-DAY combined neurodiversity-affirming and cognitive behavioral approaches to target emotional reactivity and self-esteem in youth to improve depressive symptom severity in a group setting across 12 weeks. We examined the preliminary feasibility, acceptability, and efficacy of CBT-DAY in a pilot non-randomized trial. In addition, we implemented a rigorous protocol for assessing, monitoring, and addressing potential harms in this intervention. Results from 24 autistic youth (11-17 years old) suggest that CBT-DAY may be feasible to use in an outpatient clinical setting and generally acceptable to youth and their caregivers. Participation in CBT-DAY may be associated with significant improvements in youth emotional reactivity and self-esteem, as well as depressive symptom severity per self-report only. Exploratory analyses showed that participation in CBT-DAY may also be associated with significant improvements in internalizing symptoms. Findings demonstrate the potential promise of neurodiversity-affirming and cognitive behavioral approaches to treating depressive symptoms in some autistic youth. En ligne : https://dx.doi.org/10.1177/13623613231213543 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=533 [article] Community-guided, autism-adapted group cognitive behavioral therapy for depression in autistic youth (CBT-DAY): Preliminary feasibility, acceptability, and efficacy [texte imprimé] / Marissa C. ROTH, Auteur ; Ann V. PATERSON, Auteur ; Alexandra X. JACOBS, Auteur ; Zachary J. WILLIAMS, Auteur . - p.1902-1918. Langues : Anglais (eng) in Autism > 28-8 (August 2024) . - p.1902-1918 Mots-clés : autism  cognitive behavioral therapy  community-guided intervention  depression  harms monitoring  youth Index. décimale : PER Périodiques Résumé : This study examined the preliminary feasibility, acceptability, and efficacy of an autism-adapted cognitive behavioral therapy for depression in autistic youth, CBT-DAY. Twenty-four autistic youth (11-17 years old) participated in the pilot non-randomized trial including 5 cisgender females, 14 cisgender males, and 5 non-binary youth. Youth participated in 12 weeks of, CBT-DAY and youth depressive symptoms (i.e., primary clinical outcome) and emotional reactivity and self-esteem (i.e., intervention mechanisms) were assessed through self-report and caregiver report at four timepoints: baseline (week 0), midpoint (week 6), post-treatment (week 12), and follow-up (week 24). Results suggested that CBT-DAY may be feasible (16.67% attrition) in an outpatient setting and acceptable to adolescents and their caregivers. Bayesian linear mixed-effects models showed that CBT-DAY may be efficacious in targeting emotional reactivity [?T1-T3 = 2.53, CrI95% ( 4.62, 0.58), Pd = 0.995, d = 0.35] and self-esteem [?T1-T3 = 3.57, CrI95% ( 5.17, 2.00), Pd > 0.999, d = 0.47], as well as youth depressive symptom severity [? = 2.72, CrI95% ( 3.85, 1.63), Pd > 0.999]. Treatment gains were maintained at follow-up. A cognitive behavioral group therapy designed for and with autistic people demonstrates promise in targeting emotional reactivity and self-esteem to improve depressive symptom severity in youth. Findings can be leveraged to implement larger, more controlled trials of CBT-DAY. The trial was registered at Clinicaltrials.gov (Identifier: NCT05430022; https://beta.clinicaltrials.gov/study/NCT05430022). Lay Abstract Depression in youth is a significant public health problem worldwide, particularly for autistic youth who are over twice as likely to experience depression than their non-autistic peers. Although pathways to depression are complex, emotional reactivity and negative self-esteem are two risk factors for depression in autistic and non-autistic youth. Although autistic youth are more likely to experience depression than their non-autistic peers, psychotherapy options for autistic youth are very limited; community guidance in the development and testing of psychotherapy programs is a promising approach in autism. Therefore, in this study, we designed an autism-adapted CBT-DAY, in collaboration with autistic community members. Specifically, CBT-DAY combined neurodiversity-affirming and cognitive behavioral approaches to target emotional reactivity and self-esteem in youth to improve depressive symptom severity in a group setting across 12 weeks. We examined the preliminary feasibility, acceptability, and efficacy of CBT-DAY in a pilot non-randomized trial. In addition, we implemented a rigorous protocol for assessing, monitoring, and addressing potential harms in this intervention. Results from 24 autistic youth (11-17 years old) suggest that CBT-DAY may be feasible to use in an outpatient clinical setting and generally acceptable to youth and their caregivers. Participation in CBT-DAY may be associated with significant improvements in youth emotional reactivity and self-esteem, as well as depressive symptom severity per self-report only. Exploratory analyses showed that participation in CBT-DAY may also be associated with significant improvements in internalizing symptoms. Findings demonstrate the potential promise of neurodiversity-affirming and cognitive behavioral approaches to treating depressive symptoms in some autistic youth. En ligne : https://dx.doi.org/10.1177/13623613231213543 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=533

Community-guided measurement-based care for autistic youth and adults receiving psychotherapy: A conceptual overview and pilot implementation study of MBC-AUT / Jessica M. SCHWARTZMAN in Autism, 27-6 (August 2023)  

Public ISBD [article]  inAutism > 27-6 (August 2023) . - p.1658-1675 Titre : Community-guided measurement-based care for autistic youth and adults receiving psychotherapy: A conceptual overview and pilot implementation study of MBC-AUT Type de document : texte imprimé Auteurs : Jessica M. SCHWARTZMAN, Auteur ; Zachary J WILLIAMS, Auteur ; Ann V. PATERSON, Auteur ; Alexandra X. JACOBS, Auteur ; Blythe A. CORBETT, Auteur Article en page(s) : p.1658-1675 Langues : Anglais (eng) Mots-clés : autism;community members;measurement-based care;psychotherapy Index. décimale : PER Périodiques Résumé : Measurement-based care is an approach to clinical care that involves systematically evaluating patient-reported outcomes to guide clinical decision making with a strong evidence base in the general population; however, its use in autism is limited. As autistic people are more likely to be diagnosed with psychiatric disorders (e.g. depression, anxiety) and to use psychiatric services (e.g. psychotherapy) than the general population, efforts to enhance clinical care for this population are critical. The current proof-of-concept study presents the development and pilot administration of an autism-adapted measurement-based care (MBC-AUT) system for psychotherapy designed for and with autistic people, as well as preliminary data on the feasibility, acceptability, benefits, and barriers to the adoption of the system for clients and clinicians. Findings from the first 18 youth and adult clients to use the system suggest that the MBC-AUT system is feasible and acceptable. Important benefits of the MBC-AUT system for clients and clinicians were identified through semi-structured interviews, and some barriers to the use of the MBC-AUT system were raised. Potential solutions are presented to address these barriers and to reduce the client and clinician burden. As autistic clients continue to seek psychological services, efforts to enhance the delivery and quality of psychotherapy for this population are essential.Lay abstractAutistic youth and adults are more likely to experience psychiatric symptoms (e.g. depression, anxiety) and to use psychiatric services than non-autistic people, yet research on evidence-based approaches to enhance psychiatric care for autistic people is limited. Measurement-based care is an evidence-based approach to psychotherapy that improves outcomes for clients, clinicians, and organizations by routinely administering and evaluating measures to clients. Despite this, research on measurement-based care systems for autistic clients is sparse. To address this gap, we developed an autism-adapted measurement-based care (MBC-AUT) system for and with autistic people and pilot tested the system in an outpatient psychiatry clinic to investigate the preliminary feasibility, acceptability, benefits, and barriers to this system for clients and clinicians. Findings suggested that the MBC-AUT system was a feasible and acceptable system for the first 18 autistic youth, their caregivers, and autistic adults to use the system. In semi-structured interviews, clients and clinicians discussed the benefits of the MBC-AUT system to various therapeutic processes, as well as several important barriers to the use of the system. We offer potential solutions to address these barriers and to reduce client and clinician burden, and propose future directions for this line of research to increase access to more autistic people. As autistic clients continue to seek psychological services amid social landscapes of increasing complexity (e.g. COVID-19 pandemic), efforts to enhance the delivery of psychotherapy for this population are critical. En ligne : http://dx.doi.org/10.1177/13623613221143587 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=509 [article] Community-guided measurement-based care for autistic youth and adults receiving psychotherapy: A conceptual overview and pilot implementation study of MBC-AUT [texte imprimé] / Jessica M. SCHWARTZMAN, Auteur ; Zachary J WILLIAMS, Auteur ; Ann V. PATERSON, Auteur ; Alexandra X. JACOBS, Auteur ; Blythe A. CORBETT, Auteur . - p.1658-1675. Langues : Anglais (eng) in Autism > 27-6 (August 2023) . - p.1658-1675 Mots-clés : autism;community members;measurement-based care;psychotherapy Index. décimale : PER Périodiques Résumé : Measurement-based care is an approach to clinical care that involves systematically evaluating patient-reported outcomes to guide clinical decision making with a strong evidence base in the general population; however, its use in autism is limited. As autistic people are more likely to be diagnosed with psychiatric disorders (e.g. depression, anxiety) and to use psychiatric services (e.g. psychotherapy) than the general population, efforts to enhance clinical care for this population are critical. The current proof-of-concept study presents the development and pilot administration of an autism-adapted measurement-based care (MBC-AUT) system for psychotherapy designed for and with autistic people, as well as preliminary data on the feasibility, acceptability, benefits, and barriers to the adoption of the system for clients and clinicians. Findings from the first 18 youth and adult clients to use the system suggest that the MBC-AUT system is feasible and acceptable. Important benefits of the MBC-AUT system for clients and clinicians were identified through semi-structured interviews, and some barriers to the use of the MBC-AUT system were raised. Potential solutions are presented to address these barriers and to reduce the client and clinician burden. As autistic clients continue to seek psychological services, efforts to enhance the delivery and quality of psychotherapy for this population are essential.Lay abstractAutistic youth and adults are more likely to experience psychiatric symptoms (e.g. depression, anxiety) and to use psychiatric services than non-autistic people, yet research on evidence-based approaches to enhance psychiatric care for autistic people is limited. Measurement-based care is an evidence-based approach to psychotherapy that improves outcomes for clients, clinicians, and organizations by routinely administering and evaluating measures to clients. Despite this, research on measurement-based care systems for autistic clients is sparse. To address this gap, we developed an autism-adapted measurement-based care (MBC-AUT) system for and with autistic people and pilot tested the system in an outpatient psychiatry clinic to investigate the preliminary feasibility, acceptability, benefits, and barriers to this system for clients and clinicians. Findings suggested that the MBC-AUT system was a feasible and acceptable system for the first 18 autistic youth, their caregivers, and autistic adults to use the system. In semi-structured interviews, clients and clinicians discussed the benefits of the MBC-AUT system to various therapeutic processes, as well as several important barriers to the use of the system. We offer potential solutions to address these barriers and to reduce client and clinician burden, and propose future directions for this line of research to increase access to more autistic people. As autistic clients continue to seek psychological services amid social landscapes of increasing complexity (e.g. COVID-19 pandemic), efforts to enhance the delivery of psychotherapy for this population are critical. En ligne : http://dx.doi.org/10.1177/13623613221143587 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=509

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