Abstract
Background:
Despite their increased need for mental health support, Autistic adults often report dissatisfaction with the care they receive. Although research focused on barriers and limitations to health care for Autistic adults is informative, it may not offer guidance to professionals looking to learn about how to meet the needs of Autistic clients. Limited research has explored Autistic adults' interactions with psychologists, and no known study has explored their positive therapy experiences.
Methods:
We conducted semi-structured online interviews with nine Autistic adults (aged 20–46 years) in Australia to learn about their positive experiences working with psychologists.
Results:
We developed four primary themes and nine subthemes using Reflexive Thematic Analysis. Primary themes included (1) “A Clear Sense of Direction,” (2) “Understand the Autistic Brain,” (3) “Creating a Safe Space,” and (4) “A Huge Flow on Impact.” Participants described having worked with psychologists who understood Autism, were flexible and accommodating, followed a strengths-based approach, and facilitated self-understanding and self-acceptance through helping clients to feel heard and validated.
Conclusion:
There are actions psychologists can take to promote a positive therapy experience for Autistic adults, and relational factors that facilitate a positive experience. A positive therapy experience can contribute to Autistic adult clients feeling heard and validated, which can have a flow on impact to improve their self-perception. We have developed a proposed model of care that outlines accommodations psychologists can consider when providing therapy to Autistic adults.
Community brief
“Why is this an important issue?”
Autistic adults are more likely to have mental health concerns than non-Autistic adults. Yet, when asked about their experiences of seeking professional support and care, Autistic adults report mental health services are not well matched to their needs. It is important to understand what helps create a positive experience for Autistic adults when receiving care for their mental health.
“What was the purpose of this study?”
We wanted to learn from Autistic adults who have had a positive experience when seeing a psychologist in Australia because their experiences could help us understand what works well in therapy.
“What did the researchers do?”
We interviewed nine Australian Autistic adults who had a positive experience with a psychologist. We developed the interview questions in collaboration with an Autistic advisor. Participants told us about what made the therapeutic experience positive for them. We then looked at what each person told us and interpreted common patterns or themes.
“What were the results of the study?”
We interpreted four themes that helped summarize the positive experiences with psychologists that participants told us about. (1) A Clear Sense of Direction: When the psychology sessions were structured, clear, and consistent, the participants knew what to expect so felt more comfortable. (2) Understand the Autistic Brain: The psychologist having a good understanding of Autism meant they could share their knowledge, and use the knowledge to make sense of the client's experiences. (3) Creating a Safe Space: The participants felt more comfortable when the psychologist was genuine and authentic, which meant they felt safe in the therapeutic relationship. They felt safe when the psychologist was flexible, accommodating, and strengths-based. (4) A Huge Flow on Impact: The Autistic adults in the study told us through supportive therapy, they felt validated, and this helped them be more self-accepting and self-compassionate.
We used these themes to create an initial model of therapy that could be used to guide psychologists wanting to learn more about working with Autistic adults.
“What do these findings add to what was already known?”
This study brings in new information about positive experiences working with psychologists. The stories participants told us, and the model we built from their data, might help other psychologists adapt their practice to provide positive therapy experiences to Autistic adults. Participants' stories offer insights into the importance and meaning they have made from attending therapy with a supportive psychologist.
“What are potential weaknesses in the study?”
Our study captures the experiences of a small group of Autistic adults in Australia. Many of the participants were late-diagnosed and assigned female at birth. Exploring perspectives from a more diverse group would help to further our understanding of this topic.
“How will these findings help Autistic adults now or in the future?”
The model of care we developed has the potential to improve the mental health support provided to Autistic adults from psychologists. The information could be shared with more psychologists as part of their training or professional development.
Get full access to this article
View all access options for this article.