Sticking with It: Psychotherapy Outcomes for Adults with ASD in a University Counseling Center
Young adults with autism spectrum disorders (ASD) experience high rates of comorbid mental health concerns as well as distress arising from the core symptoms of autism. Many adults with ASD seek psychological treatment in outpatient facilities in their communities that are not specifically geared towards individuals with ASD. However, few studies have looked at the effectiveness of standard psychotherapeutic care in adults with ASD.
This study aims to discover how individuals with autism spectrum disorders fare in psychotherapy within a college mental health care setting compared to their neuro-typical peers.
Data for this study were pulled from a large data set containing information on 34874 clients that visited the Brigham Young University Counseling and Psychological Services (CAPS) center for psychotherapy from 1994-2015. Therapy case notes (N=271,343) were searched for terms associated with autism spectrum disorders (“autism,” “Asperger’s,” “spectrum,” etc.) and each flagged case note was coded for the diagnostic relevance of the term. Finally, each client’s case note ratings were merged and a final diagnostic code was determined: Confirmed ASD (CASD)(N=95), Probable ASD but is not diagnosed (PASD)(N=109), or Does not have ASD (Neuro-typical, NT)(N=34670).
The CAPS uses the Outcome Questionnaire-45 (OQ) to track distress at each session. The well-validated OQ-45 is generally completed shortly before every session the client attends and has been shown to be sensitive to change across the course of therapy. Change in OQ scores across sessions was analyzed with a repeated measure mixed model using lag 1 autocorrelation to account for within subject correlation.
Clients with confirmed or probable ASD showed no difference in level of distress at intake compared to their neuro-typical peers (CASD, M = 68.1; PASD, M = 69.4; NT, M = 67.4; p = .90). However, clients with confirmed and probable ASD stayed in treatment for a significantly larger number of sessions than neuro-typical clients (CASD, M = 6.7; PASD, M = 6.0; NT, M = 4.2; p < .001). Clients with confirmed ASD also improved at a faster rate in therapy than neuro-typical clients, especially after the first five sessions. We are undertaking additional analyses to look at the relationship between OQ-45 scores at intake and eventual outcome.
Overall, adult therapy clients with autism spectrum disorder appear to benefit from typical community psychotherapy approaches as much or even more than their neuro-typical peers. They also tend to stay in therapy longer than their peers, which may indicate that they do not feel relief of distress as quickly and require more sessions to feel as though therapy was successful. Results indicate that adults with ASD benefit greatly from psychotherapy the longer they stick with it, and should be encouraged to continue in therapy even if they do not feel immediately that it is helping.