Acceptance and Commitment Therapy (ACT)-Based Stress Management for High-Functioning Autism Spectrum Disorder (ASD)

Background: Autism spectrum disorder (ASD) is a neurodevelopmental disorder associated with depression, anxiety and stress, as well as decreased quality of life. ACT processes target core difficulties in ASD, such as psychological inflexibility, and has been shown efficient in reducing stress and psychological distress as well as increasing quality of life, although not yet evaluated for this population.

Objectives: To evaluate the efficacy and feasibility of an ACT-based stress management for adolescents and adults with high-functioning ASD.

Methods: Study 1: Using a quasi-experimental design we evaluated an adapted ACT-protocol for 28 students with ASD (aged 13–21). Study 2: Using an open trial design the ACT treatment was evaluated for adults (n=10; age range 25-65 years) in an outpatient psychiatric context. Study 3: Using an RCT design we evaluated the ACT treatment for 40 adults with ASD in an outpatient psychiatric context.

Results: Study 1: Levels of stress, hyperactivity, and emotional distress were significantly reduced and pro-social behavior was increased. Study 2: Levels of stress were significantly reduced and quality of life increased. Study 3: Significantly reduced stress and psychiatric symptoms, and increased psychological flexibility and quality of life. Autistic core symptoms were also reduced.

Conclusions: The ACT-based stress management program may be an efficient and feasible option for adolescents and adults with high-functioning ASD in reducing stress, psychological distress such as depression and anxiety as well as increasing quality of life.