A mixed methods study of autistic adults' mental health therapy experiences.

This study surveyed 303 autistic adults about their therapy experiences. Most had tried therapy, especially talking therapies. Key findings: therapists who understand autism are crucial for success, many found therapy helpful for personal growth, but talking during sessions was often challenging. Various strategies helped with anxiety and mood, but were hard to use in everyday life due to autism-related differences.

The research highlights the need for autism-informed therapists and individualized approaches.

This mixed-methods study examined mental health therapy experiences among 303 autistic adults aged 21-77. Most participants (88.8%) had received therapy, with cognitive approaches being most common. Qualitative analysis revealed that therapist acceptance and understanding were critical for success, and many found therapy helpful for personal growth. However, participants reported challenges with verbal communication during sessions and difficulty generalizing strategies to daily life.

While various strategies helped reduce anxiety and improve mood, implementation was often difficult due to autism-specific needs. The study emphasizes the importance of therapeutic relationships, communication accommodations, and individualized approach selection.

Clinicians should prioritize building accepting therapeutic relationships and understanding autism. Communication accommodations during sessions are essential. Individualized approach selection based on client preferences and autism-specific needs is recommended. Additional support for strategy generalization to daily life contexts should be considered when working with autistic clients.

As the first study of its kind, findings need replication. The study relied on self-reported experiences and may have selection bias toward those who had accessed therapy. Specific therapeutic approaches and their relative effectiveness were not quantitatively compared. The online survey format may have excluded some autistic adults.

Autistic adults are at high risk for co-occurring mental health problems and need access to effective and appropriate mental health treatment. However, the relative effectiveness or acceptability of specific mental health strategies among autistic adults has not been previously examined. The current study sought to gain a deeper understanding of autistic adults' experiences and preferences regarding mental health strategies using a mixed methods approach. Autistic adults (n = 303, ages 21-77) completed online surveys and open-ended questions about their mental health and therapy experiences.

Most (88.8%) had participated in therapy, with cognitive approaches being the most common. Regarding overall therapy experiences, qualitative analyses revealed four primary themes and nine subthemes. Therapist acceptance and understanding were seen as critical for therapy success, and many participants felt that therapy was helpful for personal growth. However, many participants found that talking in session was challenging and noted that aspects of the session format affected their ability to engage in therapy.

Regarding specific strategies, four cross-cutting themes and eight strategy-specific subthemes were identified. A variety of strategies were seen as helpful for reducing anxiety and improving mood. However, autistic adults reported trouble generalizing strategies to daily life and found some techniques to be difficult to implement due, in part, to their unique autism-related needs. As the first study of its kind, the results underscore the importance of establishing a safe and accepting therapeutic relationship, providing accommodations to support communication needs, and considering individual differences and preferences when selecting mental health strategies for autistic clients.