Enhancing therapy processes with and for autistic people

Three people sitting and talking

Autistic people are more likely to experience mental health distress than the general population. Unfortunately, therapy services for this community are limited and rarely designed with and for autistic people. Vanderbilt Kennedy Center (VKC) researcher Jessica Schwartzman, Ph.D., recently co-authored a paper* in the journal Autism which outlines the development and testing of an autism-adapted, measurement-based care** system (MBC-AUT) to enhance therapy processes for autistic people and their families.

Schwartzman collaborated with autistic researchers, parents, and community members to design the MBC-AUT and then implemented the system in an outpatient psychiatry clinic at Vanderbilt University Medical Center with autistic people seeking therapy to understand client and clinician perspectives.

Jessica Schwartzman headshot

Jessica Schwartzman, Ph.D.

“The first component of our study focused on designing the measurement system,” said Schwartzman. “To do this, I hosted meetings with my Neurodivergent Advisory Team, a collaborative group of autistic adults, parents, and researchers with interests in improving clinical services for this community. After designing the system, I shared it with mental health professionals such as psychiatrists, researchers, and psychologists for additional feedback and revisions. The second component of the study focused on implementing the MBC-AUT system with autistic people and examining its feasibility and acceptability. Specifically, we measured several aspects of how clients and clinicians used the system, their perceptions of it, and potential benefits and barriers to using the system in practice.”

Schwartzman says feedback from clients and clinicians suggest that the system is feasible and acceptable to use, and that it provides important benefits to the therapy experiences of autistic people.

“We found that there were clear benefits to therapeutic processes for both clients and clinicians in the areas of client-clinician communication, diagnostic decisions, and treatment goals. We also identified barriers to using the system across clients and clinicians, which included things like survey fatigue and administrative time. Our study provides an important initial step into measuring and improving therapy processes for autistic people and their caregivers. Our work lays the groundwork for a feasible and acceptable measurement system that can continue to be studied and eventually implemented in other clinics and states.”

Schwartzman says next steps for this work include designing and testing iterations of MBC-AUT for autistic people with diverse communication, cognitive, and adaptive needs. And to conduct a larger-scale trial of MBC-AUT in clinical settings to explore additional benefits and barriers for clients and clinicians.

The manuscript is available online through the journal of Autism (citation below), or by emailing jesscia.schwartzman@vumc.org.

Schwartzman will discuss some of her work in mental health at the Mar. 30 VKC Conversation Series on Research in Intellectual and Developmental Disabilities, titled “Mental Health in Individuals with IDD.” Learn more and register here for this virtual conversation.


* Schwartzman JM, Williams ZJ, Paterson AV, Jacobs AX, Corbett BA. Community-guided measurement-based care for autistic youth and adults receiving psychotherapy: A conceptual overview and pilot implementation study of MBC-AUT. Autism. 2023 Jan 11.

**Measurement-based care is an evidence-based approach to psychotherapy that improves outcomes for clients, clinicians, and organizations by routinely administering and evaluating measures to clients.

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