'Sometimes I'm feeling baffled and they're probably feeling baffled': On the experiences of psychological therapists working with autistic people in a structured primary care service for anxiety disorders and depression.

IF 5.6 2区 心理学 Q1 PSYCHOLOGY, DEVELOPMENTAL
Autism Pub Date : 2025-05-22 DOI:10.1177/13623613251341610
Paul K Miller, Samantha Lj Bowden, Natalie Dewison, Barry Ingham, Richard Thwaites, Dave Dagnan
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引用次数: 0

Abstract

Autistic people are more likely to experience mental health problems such as anxiety disorder and depression than are the general population. This study reports a qualitative analysis of interview data provided by 12 psychological therapists regarding their experiences of working with autistic people with anxiety disorders and/or depression within a structured primary care mental health service in the north of England. Interviews were analysed using thematic analysis. Four main themes were identified: (1) Experience and Trepidation, (2) Wrong Service, Only Service, (3) Therapeutic Environment and (4) Training and Adaptations. Participating therapists identified challenges in the structure of the services they worked in, the applicability of conventional therapies and the need for autism-specific therapy training ideally led by autistic people. Centrally, participants did not routinely feel fully equipped to separate endemic aspects of autism itself from features of a mental health disorder in an autistic person, which had left some feeling powerless to help in certain cases, or as if they may have done more harm than good. All participants were, however, able to identify positive adaptations made from practical experience, and most reported a growing confidence in working with autistic people.Lay AbstractThe experiences of psychological therapists working with autistic people in a primary care service for anxiety disorders and depressionWe are a group of autistic people, academic researchers and psychological therapists, with some of us being more than one of those things. We started from the knowledge that autistic people are particularly prone to have anxiety disorders and depression. We were, therefore, interested in how current 'talking therapy' services in England might, or might not, be helping autistic people with those problems. To address this issue, we interviewed 12 psychological therapists in the north of England who had experience of working with autistic people with an anxiety disorder, depression or both. We found that the therapists often felt that they were not prepared or trained to give autistic people their best service. The therapists were also concerned that some of the therapies they usually applied did not always work with autistic people, or sometimes even made things worse. They felt it was important, however, that autistic people should keep using the service, as there was no other service available to them if they had an anxiety disorder or depression. There was evidence, however, that talking therapies still had positive effects for autistic people, and that therapists had therefore probably underestimated their positive impact in a lot of cases. Consequently, training was recommended such that psychological therapists might better understand mental health and specific therapy adaptations that help autistic people.

“有时我感到困惑,他们可能也感到困惑”:关于心理治疗师在焦虑障碍和抑郁症的结构化初级保健服务中与自闭症患者合作的经验。
自闭症患者比普通人更容易出现精神健康问题,如焦虑症和抑郁症。本研究报告了对12位心理治疗师提供的访谈数据的定性分析,这些访谈数据是关于他们在英格兰北部结构化初级保健精神卫生服务中与患有焦虑症和/或抑郁症的自闭症患者一起工作的经历。访谈采用专题分析进行分析。确定了四个主题:(1)经验和恐惧,(2)错误的服务,唯一的服务,(3)治疗环境和(4)培训和适应。参与研究的治疗师发现了他们工作的服务结构中的挑战,传统疗法的适用性,以及由自闭症患者领导的自闭症特定治疗培训的必要性。最重要的是,参与者通常不觉得自己完全有能力将自闭症本身的地方性特征与自闭症患者的精神健康障碍特征区分开来,这使得一些人在某些情况下感到无力提供帮助,或者好像他们可能弊大于利。然而,所有的参与者都能够从实际经验中识别出积极的适应,而且大多数人报告说,他们在与自闭症患者一起工作时越来越有信心。心理治疗师在焦虑障碍和抑郁症的初级保健服务中与自闭症患者一起工作的经验我们是一群自闭症患者,学术研究人员和心理治疗师,我们中的一些人不止是其中之一。我们的出发点是知道自闭症患者特别容易出现焦虑症和抑郁症。因此,我们对英国目前的“谈话治疗”服务是否能帮助自闭症患者解决这些问题很感兴趣。为了解决这个问题,我们采访了英格兰北部的12位心理治疗师,他们都有治疗患有焦虑症、抑郁症或两者兼而有之的自闭症患者的经验。我们发现治疗师经常觉得他们没有准备好或没有接受过培训,无法为自闭症患者提供最好的服务。治疗师还担心,他们通常使用的一些治疗方法并不总是对自闭症患者有效,有时甚至会使情况变得更糟。然而,他们认为自闭症患者应该继续使用这项服务很重要,因为如果他们患有焦虑症或抑郁症,就没有其他服务可供他们使用。然而,有证据表明,谈话疗法对自闭症患者仍然有积极作用,因此,治疗师可能低估了他们在很多情况下的积极作用。因此,建议进行培训,使心理治疗师能够更好地了解心理健康和帮助自闭症患者的特定治疗适应。
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来源期刊
Autism
Autism PSYCHOLOGY, DEVELOPMENTAL-
CiteScore
9.80
自引率
11.50%
发文量
160
期刊介绍: Autism is a major, peer-reviewed, international journal, published 8 times a year, publishing research of direct and practical relevance to help improve the quality of life for individuals with autism or autism-related disorders. It is interdisciplinary in nature, focusing on research in many areas, including: intervention; diagnosis; training; education; translational issues related to neuroscience, medical and genetic issues of practical import; psychological processes; evaluation of particular therapies; quality of life; family needs; and epidemiological research. Autism provides a major international forum for peer-reviewed research of direct and practical relevance to improving the quality of life for individuals with autism or autism-related disorders. The journal''s success and popularity reflect the recent worldwide growth in the research and understanding of autistic spectrum disorders, and the consequent impact on the provision of treatment and care. Autism is interdisciplinary in nature, focusing on evaluative research in all areas, including: intervention, diagnosis, training, education, neuroscience, psychological processes, evaluation of particular therapies, quality of life issues, family issues and family services, medical and genetic issues, epidemiological research.
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