.2023 Mar 1;77(2):7702185070.

doi: 10.5014/ajot.2023.050108.

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

Laura Graham Holmes¹, Russell J Goebel², Calliope Hollingue³, Shuning Zhu⁴, Handing Zhang⁵, Wuji Shan⁶, Shicong Wang⁷, Reid Caplan⁸, Amelia Sanchez⁹, Peter Wharmby¹⁰, Melody Chiang¹¹, Mariah Person¹², Emily F Rothman¹³

Affiliations

¹ Laura Graham Holmes, PhD, is Assistant Professor, Silberman School of Social Work, Hunter College, City University of New York, New York, NY.
² Russell J. Goebel, BS, is PhD Candidate, Department of Mathematics and Statistics, Boston University, Boston, MA.
³ Calliope Hollingue, PhD, is Assistant Professor, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD.
⁴ Shuning Zhu, MSc, is Student, Department of Mathematics and Statistics, Boston University, Boston, MA.
⁵ Handing Zhang, MSc, is Student, Department of Mathematics and Statistics, Boston University, Boston, MA.
⁶ Wuji Shan, MSc, is Student, Department of Mathematics and Statistics, Boston University, Boston, MA.
⁷ Shicong Wang, MSc, is Student, Department of Mathematics and Statistics, Boston University, Boston, MA.
⁸ Reid Caplan, BA, is Community Advisor, HEARTS Advisory Board, Boston, MA.
⁹ Amelia Sanchez is Community Advisor, HEARTS Advisory Board, Boston, MA.
¹⁰ Peter Wharmby, MA, is Community Advisor, HEARTS Advisory Board, Boston, MA.
¹¹ Melody Chiang is Community Advisor, HEARTS Advisory Board, Boston, MA.
¹² Mariah Person is Community Advisor, HEARTS Advisory Board, Boston, MA.
¹³ Emily F. Rothman, ScD, is Professor and Chair, Department of Occupational Therapy, Boston University, Boston, MA; erothman@bu.edu.

PMID:37040101
PMCID: PMC10137597
DOI: 10.5014/ajot.2023.050108

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

Laura Graham Holmes et al. Am J Occup Ther.2023.

.2023 Mar 1;77(2):7702185070.

doi: 10.5014/ajot.2023.050108.

Authors

Affiliations

¹ Laura Graham Holmes, PhD, is Assistant Professor, Silberman School of Social Work, Hunter College, City University of New York, New York, NY.
² Russell J. Goebel, BS, is PhD Candidate, Department of Mathematics and Statistics, Boston University, Boston, MA.
³ Calliope Hollingue, PhD, is Assistant Professor, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD.
⁴ Shuning Zhu, MSc, is Student, Department of Mathematics and Statistics, Boston University, Boston, MA.
⁵ Handing Zhang, MSc, is Student, Department of Mathematics and Statistics, Boston University, Boston, MA.
⁶ Wuji Shan, MSc, is Student, Department of Mathematics and Statistics, Boston University, Boston, MA.
⁷ Shicong Wang, MSc, is Student, Department of Mathematics and Statistics, Boston University, Boston, MA.
⁸ Reid Caplan, BA, is Community Advisor, HEARTS Advisory Board, Boston, MA.
⁹ Amelia Sanchez is Community Advisor, HEARTS Advisory Board, Boston, MA.
¹⁰ Peter Wharmby, MA, is Community Advisor, HEARTS Advisory Board, Boston, MA.
¹¹ Melody Chiang is Community Advisor, HEARTS Advisory Board, Boston, MA.
¹² Mariah Person is Community Advisor, HEARTS Advisory Board, Boston, MA.
¹³ Emily F. Rothman, ScD, is Professor and Chair, Department of Occupational Therapy, Boston University, Boston, MA; erothman@bu.edu.

PMID:37040101
PMCID: PMC10137597
DOI: 10.5014/ajot.2023.050108

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).

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Figures

**Figure 1.**
HEARTS conceptual model diagram.Note. HEARTS = Healthy Relationships on the Autism Spectrum.

See this image and copyright information in PMC

Cited by

Autism and Mental Health: The Role of Occupational Therapy.
Kirby AV, Morgan L, Hilton C.Kirby AV, et al.Am J Occup Ther. 2023 Mar 1;77(2):7702170010. doi: 10.5014/ajot.2023.050303.Am J Occup Ther. 2023.PMID:36996455Free PMC article.

References

1. Adams, R., Bishop, S., & Taylor, J. L. (2017). Negative peer experiences in adolescents with autism spectrum disorders. In Fisher M. H. (Ed.), International review of research in developmental disabilities (Vol. 52, pp. 75–107). Academic Press.
1. Autistic Self Advocacy Network. (2020). Identify-first language.https://autisticadvocacy.org/about-asan/identity-first-language/
1. Autistic Self Advocacy Network. (2022). About autism.https://autisticadvocacy.org/about-asan/about-autism/
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1. Brenes, G. A., Guralnik, J. M., Williamson, J. D., Fried, L. P., Simpson, C., Simonsick, E. M., & Penninx, B. W. J. H. (2005). The influence of anxiety on the progression of disability. Journal of the American Geriatrics Society , 53, 34–39. 10.1111/j.1532-5415.2005.53007.x - DOI - PMC - PubMed

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

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

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