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. 2023 Mar 1;77(2):7702185070.
doi: 10.5014/ajot.2023.050108.

Reductions in Depression and Anxiety Among Autistic Adults Participating in an Intervention to Promote Healthy Relationships

Laura Graham Holmes  1 , Russell J Goebel  2 , Calliope Hollingue  3 , Shuning Zhu  4 , Handing Zhang  5 , Wuji Shan  6 , Shicong Wang  7 , Reid Caplan  8 , Amelia Sanchez  9 , Peter Wharmby  10 , Melody Chiang  11 , Mariah Person  12 , Emily F Rothman  13
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Reductions in Depression and Anxiety Among Autistic Adults Participating in an Intervention to Promote Healthy Relationships

Laura Graham Holmes et al. Am J Occup Ther. .

Abstract

Importance: Some autistic adults experience depression and anxiety related to their social relationships. There is a need for evidence-based occupational therapy interventions that decrease depression and anxiety and improve the health of social relationships for autistic adults.

Objective: To determine the feasibility and preliminary effectiveness of the Healthy Relationships on the Autism Spectrum (HEARTS) intervention, a six-session, group-based psychoeducational intervention for the improvement of relationship health.

Design: One-group pretest-posttest design with a 3-mo follow-up after baseline.

Setting: United States; online intervention through community organization.

Participants: Fifty-five adults, ages 20 to 43 yr, with a professional or self-diagnosis of autism and the capacity to independently participate in an online, group-based, participatory class.

Intervention: Participants received 6 90-min weekly sessions that addressed healthy relationship topics, including recognizing abuse, meeting people, maintaining relationships, setting interpersonal boundaries, neurohealth for relationships, and ending relationships. A psychoeducational approach that provided education and involved guided discovery and strategy acquisition was used.

Outcomes and measures: All measures were self-administered through an online survey. Depression and anxiety were assessed using instruments from the Patient-Reported Outcomes Measurement Information System.

Results: Fifty-five participants completed the intervention. Postintervention scores revealed statistically significant improvements in depression and anxiety.

Conclusions and relevance: HEARTS is a promising intervention for improving depression and anxiety among autistic adults and should be investigated further. What This Article Adds: HEARTS offers a potentially effective, nonpharmacological, psychoeducational group-based intervention option to promote healthy relationships for autistic adults. Positionality Statement: This article uses identity-first language (autistic person) in accordance with the preference of autistic self-advocates (Autistic Self Advocacy Network, 2020; Kenny et al., 2016; Lord et al., 2022).

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Figures

Figure 1.
Figure 1.
HEARTS conceptual model diagram. Note. HEARTS = Healthy Relationships on the Autism Spectrum.
See this image and copyright information in PMC

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