Community-guided measurement-based care for autistic youth and adults receiving psychotherapy: A conceptual overview and pilot implementation study of MBC-AUT.

The sample was small (18 clients) and came from one psychiatry outpatient clinic, so findings may not apply to other settings or larger groups. There was no control group, so the study cannot show that the system improved therapy compared with usual care. Changes in acceptability ratings over time were not tested because the sample was small. Differences between adolescents, caregivers, and adults were not tested because the sample was small. All clients had access to therapy and insurance, which many autistic people do not, so results may not generalise. Clinicians had autism expertise, so results may not reflect community settings with less specialized staff. The system was only tested in outpatient psychotherapy, not higher-level care. The survey battery excluded clients with intellectual disability, language barriers, or blindness, so it does not cover many autistic clients. The clinic mainly served depression, anxiety, and suicidal thoughts, so the system was not tested for conditions such as PTSD or eating disorders. Adolescents knew caregivers would review responses, which may have changed how they answered. Implementation barriers were explored only at one academic clinic, so other settings may face different barriers. The system was still being iterated, and not all possible measure combinations were tested.

The supplied publication types list non-U.S. government and NIH extramural research support. Zachary Williams reported consulting fees from Roche, Autism Speaks, and the May Institute, stock ownership in Axsome Therapeutics, and service on the family advisory committee of the Autism Speaks Autism Care Network Vanderbilt site and the autistic researcher review board of the Autism Intervention Research Network on Physical Health. The other authors declared no conflicts. Three autistic adults who guided the design were compensated for feedback, took part in writing and review, and are co-authors.

Do not conclude that this system improves therapy outcomes or reduces symptoms. It was a small pilot of feasibility and acceptability in 18 autistic clients, with no control group and no efficacy comparison.