Feasibility, Acceptability and Preliminary Efficacy of Dialectical Behavior Therapy for Autistic Adults without Intellectual Disability: A Mixed Methods Study.
Doha Bemmouna, Romain Coutelle, Sébastien Weibel and 1 others
PMID 34626285WHAT IT FOUND
Seven autistic adults without intellectual disability completed an adapted Dialectical Behavior Therapy program.
They reported high satisfaction and reduced emotion regulation difficulties that lasted four months. Self-harm and suicidal ideation decreased for most participants, though depression and hopelessness improvements did not sustain.
Key findings
01Participants reported significant improvements in emotion regulation difficulties, with mean scores decreasing post-treatment and maintaining this improvement at four-month follow-up.
02Of the four participants with self-harm, three reported complete cessation for at least three months during therapy, and no suicide attempts occurred during the study or follow-up.
03Improvements in depression and hopelessness were significant post-treatment but were not maintained at follow-up.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
The sample size was very small (n=7), limiting generalizability. There was no control group, so it is unclear if improvements were due to the therapy, natural fluctuation, or other factors. The study was disrupted by the COVID-19 pandemic, which may have affected participants' mental health and the sustainability of improvements in depression and hopelessness. All outcomes were self-reported, which can be problematic in autistic individuals due to alexithymia or social desirability bias. Participants had heterogeneous ages, IQs, and severity of symptoms, making it difficult to identify who benefits most. The qualitative interviews were conducted by the therapists, which may have influenced the responses.
Declared interests
The study was funded by Fondation FondaMental. The text does not explicitly state other conflicts of interest for the authors.
The easy way to misread this
Do not interpret these results as proof that DBT is an effective treatment for autistic adults. This was a small, uncontrolled pilot study with no comparison group. The improvements in emotion regulation may reflect natural variation or non-specific therapy effects. Additionally, the lack of sustained improvement in depression and hopelessness suggests that the benefits may be limited to specific domains and may not be durable without ongoing support.