The feasibility of low intensity psychological therapy for co-occurring depression in adult Autism: The ADEPT study - a pilot randomised controlled trial

Low intensity cognitive behaviour therapy (CBT) including behavioural activation is an evidence based treatment for depression, a condition frequently co-occurring with autism. The feasibility of adapting low intensity CBT for depression to meet the needs of autistic adults via a randomised controlled trial (RCT) was investigated. The adapted intervention (Guided Self-Help; GSH) comprised materials for 9 individual sessions with a low intensity psychological therapist. Autistic adults (n=70) with depression (PHQ-9 score ≥10) recruited from National Health Service adult autism services and research cohorts were randomly allocated to GSH or Treatment as Usual (TAU). Outcomes at 10, 16 and 24 weeks post-randomisation were blind to treatment group. Rates of retention in the study differed by treatment group with more participants attending follow-up in the GSH group than TAU. The adapted intervention was well-received, 86% (n=30/35) of participants attended the pre-defined ‘dose’ of 5 sessions of treatment and 71% (25/35) attended all treatment sessions. The findings of this pilot RCT indicate that low intensity CBT informed by Behavioural Activation can be successfully adapted to meet the needs of autistic people. Evaluation of the effectiveness of this intervention in a full scale RCT is now warranted.