27708
Qualitative Evaluation of a Low Intensity Psychological Intervention for Depression in Adults with Autism: The Autism Depression Trial (ADEPT)
High rates of co-occurring depression are reported in Autism Spectrum Disorder (ASD). Cognitive behavioural interventions adapted for ASD have been effective for anxiety problems. There have been evaluation studies of group CBT for co-occurring depression, but no randomised trials investigating low intensity psychological interventions as recommended in clinical guidelines for mild-moderate depression.
Objectives:
This study was a nested qualitative evaluation of the acceptability and feasibility of the ADEPT pilot randomised controlled trial. Participants (with a prior diagnosis of ASD and current depression as measured by PHQ-9 score ≥ 10) were randomised to Guided Self-Help (GSH): a low intensity psychological intervention based on Behavioural Activation adapted for ASD, or Treatment as Usual (TAU).
Methods:
Interviews in two locations in the United Kingdom were conducted with 18 trial participants and 4 therapists. Purposive sampling was used to select participants in order to capture maximum variation in views and experiences. Data were digitally recorded, transcribed verbatim and analysed thematically supported by qualitative data analysis software NVivo10.
Results:
Trial participants and therapists considered the intervention and trial to be acceptable and feasible. All participants welcomed an ASD focused intervention for depression due to the current lack of provision in mainstream services. For therapists the training and supervision was well received and all felt confident delivering GSH. Therapists felt GSH was appropriate to meet the needs of the majority of trial participants. Trial participants who received GSH appreciated the therapists having a good understanding of ASD and were positive towards the aim and structure of the GSH intervention. Suggested improvements that may have enhanced trial participants’ engagement in the GSH therapy included session alterations, more regularly checking progress with therapy goals, and increasing the personalisation and presentation of materials.
Conclusions:
The findings support the proposal to carry out a larger scale randomised controlled trial, and also provide evidence to refine the trial design to increase feasibility and acceptability to both trial participants and therapists.