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Cited by 10Autism Spectrum Disorder ResearchPsychotherapy Techniques and ApplicationsAnxiety, Depression, Psychometrics, Treatment, Cognitive Processes

Community-guided measurement-based care for autistic youth and adults receiving psychotherapy: A conceptual overview and pilot implementation study of MBC-AUT

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Schwartzman, Jessica M, Williams, Zachary J, Paterson, Ann V, Jacobs, Alexandra X, Corbett, Blythe A·2023·Autism
DOI 10.1177/13623613221143587PMC PMC10333447
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Abstract

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 abstract: Autistic 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.

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  • There has been little research on distress tolerance, behavioral activation, and depressive and anxiety symptoms in autistic adolescents to guide diagnostic practices and treatment planning.

    “To our knowledge, there has been little research on distress tolerance, behavioral activation, and depressive and anxiety symptoms in autistic adolescents to guide diagnostic practices and treatment planning.”

    From The relationship between distress tolerance and behavioral activation on anxiety and depression symptomatology in autistic youth: Leveraging self and caregiver perspectives (2024) · cites this paper as Schwartzman et al., 2023

    The Methods section (“Measure selection for the MBC-AUT”; page unavailable) says evidence on psychiatric risk and protective factors in autism is limited and includes distress intolerance among the factors considered. It does not make the more specific claim that research jointly examining distress tolerance, behavioral activation, and depressive and anxiety symptoms in autistic adolescents is scarce; behavioral activation appears only in a reference title. (LLM, conf=0.85)

    Experimental — accuracy not yet measured

  • Few studies have specifically examined the broad construct of distress tolerance or behavioral activation in autism.

    “Despite an increasing focus on ER in autistic individuals (Cai et al., 2018), few studies have specifically examined the broad construct of DT or BA in autism (Eldeeb et al., 2021; Schwartzman et al., 2023)”

    From The relationship between distress tolerance and behavioral activation on anxiety and depression symptomatology in autistic youth: Leveraging self and caregiver perspectives (2024) · cites this paper as Schwartzman et al., 2023

    The Methods section (Measure selection for the MBC-AUT; page unavailable) says the evidence base for psychiatric risk and protective factors in autism is limited and lists distress intolerance among those factors. It does not specifically say that few studies have examined the broad construct of distress tolerance, and its reference to behavioral activation does not establish a research gap for that topic. (LLM, conf=0.82)

    Experimental — accuracy not yet measured

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Cited by

Sorted by citations

Authors
Schwartzman, J. M., Williams, Z. J., Paterson, A. V., Jacobs, A. X., & Corbett, B. A.
Affiliations
  • Vanderbilt University Medical Center (US)
  • Vanderbilt University (US)
  • Williams Baptist University, USA
  • Community Member, Los Angeles, CA, USA
Corresponding author
Schwartzman, Jessica M
ORCID
Venue
Autism
Publisher
SAGE Publications
Published
2023-01-11
Volume
27
Issue
6
Pages
1658-1675
ISSN
  • 1362-3613 (ISSN-L)
  • 1461-7005
DOI
10.1177/13623613221143587
PMC
PMC10333447
OpenAlex
W4315651645
Cited by
10
References
27
Citations by year
2026: 1 · 2025: 1 · 2024: 6 · 2023: 2
FWCI
0.35
Type
journal article
Language
en
Open access
Licence
journals.sagepub.com/page/policies/text-and-data-mining-license (tdm)
Locations
  • Autism (publishedVersion)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
Funders
  • Vanderbilt University Medical Center, Department of Psychiatry and Behavioral Sciences
  • National Center for Advancing Translational Sciences (CTSA UL1TR000445)
Topics
  • Life Sciences › Neuroscience › Cognitive Neuroscience › Autism Spectrum Disorder Research
  • Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
Keywords
measurement-based care, autistic youth, autistic adults, psychotherapy, patient-reported outcomes, psychiatric nursing, feasibility, acceptability, implementation barriers, clinical decision-making, depression, anxiety, outpatient psychiatry, caregiver involvement, clinician burden, access to mental health care
MeSH terms
Autism Spectrum Disorder, COVID-19, Adolescent, Adult, Autistic Disorder, Humans, Psychotherapy, Pandemics

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