Anxiety in adults with autism: Perspectives from practitioners

•Anxiety affects a large proportion of the autistic population and can have a significant impact on the lives of these individuals.•Thematic analysis was used to analyse interviews with practitioners who work closely with adults who are on the spectrum and have anxiety.•Practitioners often modify their standard anxiety interventions to suit adults with autism but this varies and is inconsistent.•Practitioners also reported thinking inventively and that adults with autism may particularly benefit from continued support with anxiety.•Current measures may not accurately gauge anxiety in adults with autism. Autism is a neurodevelopmental condition, characterized by differences in social communication and social interaction as well as restricted interests and repetitive behaviours (American Psychiatric Association, 2013). Research has suggested that 50% of adults with autism meet criteria for an anxiety disorder diagnosis (Russell et al., 2013). Despite a call for multidisciplinary insights (White et al., 2018), few studies have included perspectives of practitioners in this field. We conducted interviews with eight practitioners (6 Clinical Psychologists, 1 Consultant Clinical Psychologist and 1 Nurse Practitioner) who work with adults with autism and anxiety on a regular basis. Via thematic analysis, four key themes were identified: 1. Modifications to psychological therapy 2. Thinking outside the box 3. Continued support 4. Issues with anxiety measures. Modification of standard anxiety interventions are common in practice but the course and nature of these modifications are inconsistent and may depend on practitioner experience. Practitioners may consistently have to think inventively in order to best serve adults with autism and anxiety. Current anxiety measures could be improved in order to accurately gauge anxiety, specific to adults with autism. These findings are discussed in relation to practice and future research.