Reductions in Depression and Anxiety Among Autistic Adults Participating in an Intervention to Promote Healthy Relationships

This publication is included in the Autistic Autism Scholarship Project. one author of this publication is identified as autistic in the project.

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Graham Holmes, L., Goebel, R., Holingue, C., Zhu, S., Zhang, H., Shan, W., Wang, S., Caplan, R., Sanchez, A., Wharmby, P., Chiang, M., Person, M., & Rothman, E. F. (2023). Reductions in Depression and Anxiety Among Autistic Adults Participating in an Intervention to Promote Healthy Relationships. The American Journal of Occupational Therapy, 77(2). https://doi.org/10.5014/ajot.2023.050108

Journal or book title
American Journal of Occupational Therapy
Publisher
SAGE Publications
Volume
77
Issue
2
Article number
7702185070
Publication date: 1 Mar 2023 Added to AutiHub: 5 Jul 2026 Type: Article Article language: English
Publisher source (DOI) Full text OpenAlex source

This publication is integrated into AutiHub through:

Authors

Publication authors
13
Publication authors identified as autistic
1 / 13 (7.7%)
  1. Laura Graham Holmes
  2. Russell Goebel
  3. Calliope Holingue
  4. Shuning Zhu
  5. Handing Zhang
  1. Wuji Shan
  2. Shicong Wang
  3. Reid Caplan *
  4. Amelia Sanchez
  5. Peter Wharmby
  1. Melody Chiang
  2. Mariah Person
  3. Emily F. Rothman

Abstract

IMPORTANCE: Some autistic adults experience depression and anxiety related to their social relationships. There is a need for evidence-based occupational therapy interventions that decrease depression and anxiety and improve the health of social relationships for autistic adults. OBJECTIVE: To determine the feasibility and preliminary effectiveness of the Healthy Relationships on the Autism Spectrum (HEARTS) intervention, a six-session, group-based psychoeducational intervention for the improvement of relationship health. DESIGN: One-group pretest-posttest design with a 3-mo follow-up after baseline. SETTING: United States; online intervention through community organization. PARTICIPANTS: Fifty-five adults, ages 20 to 43 yr, with a professional or self-diagnosis of autism and the capacity to independently participate in an online, group-based, participatory class. INTERVENTION: Participants received 6 90-min weekly sessions that addressed healthy relationship topics, including recognizing abuse, meeting people, maintaining relationships, setting interpersonal boundaries, neurohealth for relationships, and ending relationships. A psychoeducational approach that provided education and involved guided discovery and strategy acquisition was used. OUTCOMES AND MEASURES: All measures were self-administered through an online survey. Depression and anxiety were assessed using instruments from the Patient-Reported Outcomes Measurement Information System. RESULTS: Fifty-five participants completed the intervention. Postintervention scores revealed statistically significant improvements in depression and anxiety. CONCLUSIONS AND RELEVANCE: HEARTS is a promising intervention for improving depression and anxiety among autistic adults and should be investigated further. What This Article Adds: HEARTS offers a potentially effective, nonpharmacological, psychoeducational group-based intervention option to promote healthy relationships for autistic adults. Positionality Statement: This article uses identity-first language (autistic person) in accordance with the preference of autistic self-advocates (Autistic Self Advocacy Network, 2020; Kenny et al., 2016; Lord et al., 2022).

Bibliography cited by this reference

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Cited bibliography overview

These indicators describe the bibliography cited by this publication. An author name is counted each time it appears in one cited reference, so the same person can be counted more than once. Names not yet linked to an author already present in AutiHub are treated as unknown, not as non-autistic. Last computed: 2 Oct 2026 17:07.

Cited references
58
With a DOI
58
Without a DOI, from raw bibliography text
0
7 / 58 (12.1%) cited references include at least one author identified as autistic.
References with data to complete
1 / 58 (1.7%)
References with detected author names
57 / 58 (98.3%)
Without detected author names
1
Without a structured title
0
Without a stable identifier
0
References with raw author names still to review
0
References with external metadata lookup issues
0
These indicators apply to cited references displayed on this page, after technical duplicates have been merged. A reference without a DOI can still support author statistics when a title and author names are available.
Author names detected in the cited bibliography
338
From DOI or external metadata
338
From validated raw bibliography text
0
Raw names already validated
0
Raw names still to review
0
124 / 338 (36.7%) names are linked to an author already present in AutiHub. 214 / 338 (63.3%) names are not yet linked.
Names linked to a person identified as autistic
14 / 338 (4.1%)
Calculated across all author names detected in the cited bibliography. Among names linked to an author already present in AutiHub: 14 / 124 (11.3%). Distinct people identified as autistic: 14 / 298 (4.7%).
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