Autism Spectrum Adapted Psychotherapy for Adults (SPECTRAA): Study protocol for a randomised controlled trial of individual, short-term cognitive behavioural therapy for core autism symptomatology and common comorbidities

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Küpper, C., Elsner, B., Jörke, J., Lipinski, S., & Dziobek, I. (2026). Autism Spectrum Adapted Psychotherapy for Adults (SPECTRAA): Study protocol for a randomised controlled trial of individual, short-term cognitive behavioural therapy for core autism symptomatology and common comorbidities [Preprint]. Springer Science and Business Media LLC. https://doi.org/10.21203/rs.3.rs-8591205/v1

Publication date: 28 May 2026 Added to AutiHub: 6 Jul 2026 Type: Preprint Article language: English
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Authors

Publication authors
5
Publication authors identified as autistic
1 / 5 (20.0%)
  1. Charlotte Küpper
  2. Björn Elsner
  3. Josephine Jörke
  4. Silke Lipinski *
  5. Isabel Dziobek

Abstract

Abstract Background: Autism Spectrum Disorder is a lifelong neurodevelopmental condition with a prevalence rate of 1-2%, characterised by persistent impairments in social interaction and communication, as well as restricted and repetitive behaviours and interests. Many autistic adults without intellectual or language impairments experience challenges across multiple domains of life and commonly develop comorbid mental and somatic disorders. Despite a strong desire for therapeutic support, access to appropriate psychological or psychiatric care is often limited. Evidence-based interventions specifically tailored to autistic adults are rare. Although some group-based interventions have shown promising results, there is a lack of structured, manualised, and empirically evaluated individual therapy approaches. Such psychotherapy may offer features that align well with the treatment needs and preferences frequently reported by autistic adults, including tailored pacing, consideration of sensory and social vulnerabilities, greater predictability as well as working on individual goals. To date, the efficacy of individual cognitive-behavioural therapy (CBT) targeting core autism characteristics and common comorbidities in adults has not been systematically examined. Methods: 236 adult participants with an autism spectrum disorder will take part in a single-centre, parallel-group, pragmatic randomised controlled trial that compares an autism spectrum adapted individual manualised short-term cognitive behavioural therapy programme (SPECTRAA) with “enhanced standard care”, i.e. “treatment as usual” enhanced by a comprehensive autism-specific diagnostic process and an individual counselling session on autism-specific support services as available in Germany. The primary outcome is the Social Responsiveness Scale, completed by informants (e.g., parents, partners, or others familiar with the participant’s social communication and interaction). Patient and public involvement played a central role throughout the trial development and decision making. Discussion: This trial aims to address several gaps in the field of autism interventions. It addresses adults without intellectual disability and is the first large-scale interventional RCT to date focussing on individual CBT-based psychotherapy designed to treat core autism symptoms and common comorbidities in autistic adults. The individualised approach may enhance treatment acceptability and clinical relevance. Trial registration: German Clinical Trial Register, Trial Identifying Number: DRKS00027914, Registered on 11 April 2025

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Cited references
97
Total cited references integrated for this publication.
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6 / 97 (6.2%)
Cited author occurrences identified as autistic
6 / 424 (1.4%)
Among occurrences linked to AutiHub author records: 6 / 89 (6.7%). Distinct cited authors identified as autistic: 3 / 362 (0.8%).
Cited author occurrences linked to AutiHub author records
89 / 424 (21.0%)
Distinct linked cited authors: 52 / 362 (14.4%)
Linked cited-author occurrences not identified as autistic
83 / 89 (93.3%)
Among linked cited-author occurrences only. Across all cited-author occurrences: 83 / 424 (19.6%). Distinct linked cited authors not identified as autistic: 49 / 52 (94.2%).
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