Soins fondés sur des mesures guidés par la communauté pour les jeunes et les adultes autistes recevant une psychothérapie : aperçu conceptuel et étude pilote de mise en œuvre de MBC-AUT

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

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Schwartzman, J. M., Williams, Z. J., Paterson, A. V., Jacobs, A. X., & Corbett, B. A. (2023). Community-guided measurement-based care for autistic youth and adults receiving psychotherapy: A conceptual overview and pilot implementation study of MBC-AUT. Autism, 27(6), 1658-1675. https://doi.org/10.1177/13623613221143587

Date de publication: 11/01/2023 Ajout dans AutiHub: 07/07/2026 Type: Article Langue de l’article: Anglais
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Auteurs

Auteur·ices des publications
5
Auteur·ices de la publication identifié·es comme autistes
1 / 5 (20,0 %)
  1. Jessica M. Schwartzman
  2. Zachary J. Williams *
  3. Ann V. Paterson
  4. Alexandra X Jacobs
  5. Blythe A. Corbett

Résumé

Les soins fondés sur des mesures sont une approche des soins cliniques qui consiste à évaluer systématiquement les résultats rapportés par les patients afin d’orienter la prise de décision clinique, avec une solide base de données probantes dans la population générale ; toutefois, leur utilisation dans l’autisme est limitée. Comme les personnes autistes sont plus susceptibles que la population générale de recevoir un diagnostic de troubles psychiatriques (p. ex. dépression, anxiété) et d’utiliser des services psychiatriques (p. ex. psychothérapie), les efforts visant à améliorer les soins cliniques pour cette population sont essentiels. La présente étude de preuve de concept présente le développement et l’administration pilote d’un système de soins fondés sur des mesures adapté à l’autisme (MBC-AUT) pour la psychothérapie, conçu pour et avec des personnes autistes, ainsi que des données préliminaires sur la faisabilité, l’acceptabilité, les avantages et les obstacles à l’adoption du système pour les clients et les cliniciens. Les résultats obtenus auprès des 18 premiers jeunes et adultes clients à utiliser le système suggèrent que le système MBC-AUT est faisable et acceptable. Des avantages importants du système MBC-AUT pour les clients et les cliniciens ont été identifiés au moyen d’entretiens semi-structurés, et certains obstacles à l’utilisation du système MBC-AUT ont été soulevés. Des solutions potentielles sont présentées pour répondre à ces obstacles et réduire la charge pour les clients et les cliniciens. Alors que les clients autistes continuent de solliciter des services psychologiques, les efforts visant à améliorer la prestation et la qualité de la psychothérapie pour cette population sont essentiels. Résumé vulgarisé Les jeunes et les adultes autistes sont plus susceptibles de présenter des symptômes psychiatriques (p. ex. dépression, anxiété) et d’utiliser des services psychiatriques que les personnes non autistes, pourtant les recherches sur les approches fondées sur des données probantes visant à améliorer les soins psychiatriques pour les personnes autistes sont limitées. Les soins fondés sur des mesures constituent une approche de la psychothérapie fondée sur des données probantes qui améliore les résultats pour les clients, les cliniciens et les organisations en administrant et en évaluant régulièrement des mesures auprès des clients. Malgré cela, les recherches sur les systèmes de soins fondés sur des mesures destinés aux clients autistes sont rares. Pour combler cette lacune, nous avons développé un système de soins fondés sur des mesures adapté à l’autisme (MBC-AUT) pour et avec des personnes autistes, et avons testé le système dans le cadre d’une étude pilote au sein d’une clinique psychiatrique ambulatoire afin d’examiner la faisabilité, l’acceptabilité, les avantages et les obstacles préliminaires de ce système pour les clients et les cliniciens. Les résultats suggèrent que le système MBC-AUT était faisable et acceptable pour les 18 premiers jeunes autistes, leurs aidants et les adultes autistes qui ont utilisé le système. Lors d’entretiens semi-structurés, les clients et les cliniciens ont discuté des avantages du système MBC-AUT pour divers processus thérapeutiques, ainsi que de plusieurs obstacles importants à l’utilisation du système. Nous proposons des solutions potentielles pour répondre à ces obstacles et réduire la charge pour les clients et les cliniciens, et suggérons des orientations futures pour cette ligne de recherche afin d’élargir l’accès à un plus grand nombre de personnes autistes. Alors que les clients autistes continuent de solliciter des services psychologiques dans des contextes sociaux de complexité croissante (p. ex. pandémie de COVID-19), les efforts visant à améliorer la prestation de la psychothérapie pour cette population sont essentiels.

Measurement-based care is an approach to clinical care that involves systematically evaluating patient-reported outcomes to guide clinical decision making with a strong evidence base in the general population; however, its use in autism is limited. As autistic people are more likely to be diagnosed with psychiatric disorders (e.g. depression, anxiety) and to use psychiatric services (e.g. psychotherapy) than the general population, efforts to enhance clinical care for this population are critical. The current proof-of-concept study presents the development and pilot administration of an autism-adapted measurement-based care (MBC-AUT) system for psychotherapy designed for and with autistic people, as well as preliminary data on the feasibility, acceptability, benefits, and barriers to the adoption of the system for clients and clinicians. Findings from the first 18 youth and adult clients to use the system suggest that the MBC-AUT system is feasible and acceptable. Important benefits of the MBC-AUT system for clients and clinicians were identified through semi-structured interviews, and some barriers to the use of the MBC-AUT system were raised. Potential solutions are presented to address these barriers and to reduce the client and clinician burden. As autistic clients continue to seek psychological services, efforts to enhance the delivery and quality of psychotherapy for this population are essential. Lay abstract Autistic youth and adults are more likely to experience psychiatric symptoms (e.g. depression, anxiety) and to use psychiatric services than non-autistic people, yet research on evidence-based approaches to enhance psychiatric care for autistic people is limited. 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. Despite this, research on measurement-based care systems for autistic clients is sparse. To address this gap, we developed an autism-adapted measurement-based care (MBC-AUT) system for and with autistic people and pilot tested the system in an outpatient psychiatry clinic to investigate the preliminary feasibility, acceptability, benefits, and barriers to this system for clients and clinicians. Findings suggested that the MBC-AUT system was a feasible and acceptable system for the first 18 autistic youth, their caregivers, and autistic adults to use the system. In semi-structured interviews, clients and clinicians discussed the benefits of the MBC-AUT system to various therapeutic processes, as well as several important barriers to the use of the system. We offer potential solutions to address these barriers and to reduce client and clinician burden, and propose future directions for this line of research to increase access to more autistic people. As autistic clients continue to seek psychological services amid social landscapes of increasing complexity (e.g. COVID-19 pandemic), efforts to enhance the delivery of psychotherapy for this population are critical.

Bibliographie citée par cette référence

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Vue d’ensemble de l’inclusion dans la bibliographie

Ces indicateurs décrivent la bibliographie citée importée pour cette publication. Les métriques de références citées utilisent le total des références citées comme dénominateur. Les métriques d’auteurices cité·es indiquent si elles utilisent toutes les occurrences d’auteurices cité·es ou seulement les occurrences rattachées à des auteurices déjà intégré·es à la base de données AutiHub. Ils utilisent les rattachements mis en cache entre les auteurices cité·es et les auteurices intégré·es à la base de données AutiHub. Dernier calcul : 16/08/2026 11:31.

Références citées
77
Nombre total de références citées intégrées pour cette publication.
Références citées avec un·e auteur·ice identifié·e comme autiste
6 / 77 (7,8 %)
Occurrences d’auteur·ices cité·es identifié·es comme autistes
15 / 420 (3,6 %)
Parmi les occurrences rattachées à des auteurices intégré·es à la base de données AutiHub : 15 / 113 (13,3 %). Auteurices cité·es distinct·es identifié·es comme autistes : 13 / 377 (3,4 %).
Occurrences citées rattachées à la base AutiHub
113 / 420 (26,9 %)
Auteurices cité·es distinct·es rattaché·es : 90 / 377 (23,9 %)
Occurrences rattachées, non identifiées comme autistes
98 / 113 (86,7 %)
Parmi les seules occurrences rattachées. Sur l’ensemble des occurrences d’auteurices cité·es : 98 / 420 (23,3 %). Auteurices cité·es distinct·es rattaché·es, non identifié·es comme autistes : 77 / 90 (85,6 %).
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