Research shows that nearly 75% of autistic individuals experience mental health challenges such as anxiety, stress, and depression. However, treatment guidelines are still primarily based on neurotypical populations, leaving a gap in effective support for autistic individuals.
While therapies like Cognitive Behavioural Therapy (CBT) show promise for autistic youth without intellectual disability, findings of efficacy remain inconsistent. This highlights the need for tailored interventions that consider autism-specific cognitive, emotional, and sensory differences.
What Can Be Done Now?
Until more research emerges, clinicians must adapt evidence-based treatments to meet autistic individuals' needs. Therapy should be structured while being flexible, accommodating differences in executive function, emotional regulation, and sensory sensitivities. For those with co-occurring ADHD and autism, additional adjustments—such as predictability, and self-monitoring strategies—can enhance therapy effectiveness and prevent disengagement.
Time for innovation is now!
Our experience at Monorodi has taught us that autistic and ADHD adults may experience distress after CBT, as analysing unhelpful thoughts or behaviours can lead to fixation, rumination, and negative mood spirals. Their rigid thinking patterns and heightened self-analysis can make therapy feel overwhelming rather than constructive.
To improve outcomes, therapy should move beyond cognitive restructuring and incorporate behavioural strategies, emotion regulation techniques, and strengths-based approaches. By recognising neurodivergent needs, therapy can become an empowering tool for self-growth rather than a one-size-fits-all model.
As psychologists and psychotherapists we need to deepen our understanding of neurodevelopmental conditions to provide accessible, effective, and sustainable care.
References
Linden, A., Best, L., Elise, F., Roberts, D., Branagan, A., Tay, Y. B. E., Crane, L., Cusack, J., Davidson, B., Davidson, I., Hearst, C., Mandy, W., Rai, D., Smith, E., & Gurusamy, K. (2023). Benefits and harms of interventions to improve anxiety, depression, and other mental health outcomes for autistic people: A systematic review and network meta-analysis of randomised controlled trials. Autism : the international journal of research and practice, 27(1), 7–30. https://doi.org/10.1177/13623613221117931
Lai, M.-C., Kassee, C., Besney, R., Bonato, S., Hull, L., Mandy, W., ..., & Ameis, S. H. (2019). Prevalence of co-occurring mental health diagnoses in the autism population: A systematic review and meta-analysis. The Lancet Psychiatry, 6(10), 819-829. https://doi.org/10.1016/S2215-0366(19)30289-5
Spicer, L., DeCicco, E., Clarke, A., Ambrosius, R., & Yalcin, O. (2024). Understanding early maladaptive schemas in autistic and ADHD individuals: Exploring the impact, changing the narrative, and schema therapy considerations. Frontiers in Psychology, 15. https://doi.org/10.3389/fpsyg.2024.1436053
https://www.attwoodandgarnettevents.com/blogs/news/can-cbt-be-helpful-for-autistic-adults-part-1
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