Feasibility Study of UP-A-AST Parent Group for Adolescents With Autism and Co-occurring Anxiety/Depression

Autism spectrum disorder (ASD) is associated with high rates of psychiatric comorbidity, particularly anxiety and depressive disorders, which contribute to significant impairment for affected youth and their families. Although cognitive behavioral therapy (CBT) is recommended as a first-line treatment for anxiety and depression in children and adolescents, there is a lack of evidence-based interventions specifically adapted for youth with ASD and co-occurring emotional disorders. The Unified Protocol for Transdiagnostic Treatment of Emotional Disorders in Children and Adolescents (UP-C/UP-A) is a CBT-based intervention targeting shared mechanisms underlying anxiety and depression. A parent-mediated adaptation, the Unified Protocol-Adolescent Autism Parent Group (UP-A-AST), has been developed to address the specific needs of adolescents with ASD and co-occurring anxiety and/or depressive disorders. Preliminary quality improvement work has shown promising results. This study aims to evaluate the feasibility, acceptability, and preliminary effects of the UP-A-AST Parent Group in a child and adolescent outpatient psychiatric setting. The study will include parents of adolescents aged 12-17 years with ASD and co-occurring anxiety and/or depressive disorders. Outcomes include changes in adolescents' psychiatric symptoms and functional impairment, as well as parents' perceived parenting competence. Additionally, parents' experiences of participating in the intervention will be explored.

Inclusion Criteria: * Adolescents aged 12-17 years * Clinical diagnosis of autism spectrum disorder (ASD) according to DSM-IV, DSM-5, or ICD-10 * Current diagnosis of anxiety disorder and/or depressive disorder according to DSM-5 * Ongoing contact with a Child and Adolescent Psychiatry (BUP) outpatient clinic * Stable psychopharmacological treatment at the time of inclusion (if applicable) * Parents has participated in a psychoeducational program on autism within child and adolescent psychiatric services, or is assessed by the clinician to have equivalent knowledge Exclusion Criteria: * Presence of a severe psychiatric disorder, such as psychotic disorder, bipolar disorder, or severe eating disorder * High suicide risk or suicide attempt within the past 12 months * Severe self-injurious behavior * Intellectual disability according to DSM-5 * The adolescent is primarily in need of basic interventions for autism spectrum disorder * Parents are unable to attend all group sessions and/or lack the ability to engage in assigned home practice * Need for an interpreter