“They've almost got, like, a checklist to work down”: On the lived experiences of autistic adults who have received a structured therapy service for depression and/or anxiety disorders

Miller, Paul K. ORCID: https://orcid.org/0000-0002-5611-1354 , Dewison, Natalie, Bowden, Samantha L.J. ORCID: https://orcid.org/0009-0000-6736-2098 , Ingham, Barry, Thwaites, Richard and Dagnan, David ORCID: https://orcid.org/0000-0002-5709-1586 (2025) “They've almost got, like, a checklist to work down”: On the lived experiences of autistic adults who have received a structured therapy service for depression and/or anxiety disorders. Neurodiversity . Item availability may be restricted.

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Abstract

Autistic adults experience higher rates of common mental health conditions than nonautistic adults and report greater difficulties accessing mental health services. In England, psychological therapy for anxiety and depression is primarily delivered through NHS Talking Therapies for Anxiety and Depression (TTad), but little is yet known about autistic adults’ experiences of these services. Using Interpretative Phenomenological Analysis, we conducted in-depth online interviews with five formally diagnosed autistic adults, all in their twenties at time of interview, who had received TTad therapy for depression and/or anxiety conditions. Four superordinate themes emerged: Pre-Therapeutic Context, highlighting how participants’ autism diagnoses had been transformative, and how diagnosis had shaped their therapy experiences; Therapeutic Relationship, emphasizing the importance of a therapist’s flexibility and understanding of autism, and the damage that could be done by them minimizing the relevance of participants’ autism itself; Rigidity and Quantification, addressing challenges with standardised approaches and outcome measures; and Training and Adaptation, identifying how therapists often developed more effective approaches over time, to demonstrably positive therapeutic ends. Findings suggest that TTad services (and analogous international programmes) may require greater flexibility in delivery, enhanced autism awareness among practitioners, and potentially extended treatment timeframes for autistic clients.

Item Type:	Article
Journal / Publication Title:	Neurodiversity
Publisher:	SAGE Publications
ISSN:	2754-6330
Departments:	Institute of Health > Medical Sciences
Additional Information:	Paul K. Miller, Associate Professor in Social Psychology; Natalie Dewison; Samantha L.J. Bowden; Professor Dave Dagnan, PhD, Visiting Professor; all of the Institute of Health at the University of Cumbria, UK.
Depositing User:	Paul Miller
Date Deposited:	03 Jun 2025 09:29
Last Modified:	04 Jun 2025 08:45
URI:	https://insight.cumbria.ac.uk/id/eprint/8856