Cognitive behaviour therapy (CBT) interventions are routinely used to treat mental health conditions such as depression and generalised anxiety disorder. While CBT has most commonly been used to treat anxiety for individuals on the autism spectrum, research has provided evidence that CBT can be beneficial to support other mental health issues for individuals on the autism spectrum. However, for best practice, researchers have suggested modifications be made to programs to better suit individuals on the spectrum. These modifications include:

• use of written and visual approaches to enhance discussions and facilitate recall

• identify idiosyncratic descriptions of emotions

• use of tailored and individualised outcomes measures

• emphasise behavioural change and skill development

• use a less Socratic therapeutic style

Autistic people benefit from concrete, explicit explanations and examples utilising visual supports, social stories, checklists, mind maps etc to assist in understanding key concepts related to mental health and strategies to assist them. Read more about adapting CBT for Autistic people.

Mindfulness practices have been shown to support improved focus and reduced stress and anxiety for children and adults on the autism spectrum. Mindfulness approaches can be delivered by parents/caregivers, as well as therapists and teachers' support staff. You can read more about general mindfulness practices and mindfulness practices in the classroom on the Beyond Blue website. In addition, ARCAP’s research found that self-compassion is associated with improved mental health and wellbeing among autistic adults. ARCAP has developed the Aspect Self-compassion Program for Autistic Adults (ASPAA) to help Autistic people improve their self-compassion, emotion regulation and mental health. We conducted a pilot study involving 39 Autistic adults and found that after completing ASPAA the overall self-compassion of participants improved. A clinician version of ASPAA has also been developed for therapists and mental health workers to support Autistic clients on their self-compassion journey.

Social interactions can be difficult for individuals on the autism spectrum, therefore encouraging and supporting social interactions may be beneficial for those looking for more social opportunities. Social connections can be supported by parents, teachers, and wider community members. A number of organisations facilitate social opportunities for Autistic children and adults including Gig Buddies, Travengers, Autism Mates, Autism Adventures, Spectrum Space, Different Journeys, Empower Autism and Code Blue for Autism. A full list of local autism-friendly activities and social groups can be found on the A List website.

The ability to regulate emotions is crucial for ensuring good mental health. Autistic people process and express emotions differently. This article from Reframing Autism provides a great summary about autism and emotions. Key features of emotion regulation supports include helping an individual to understand their own emotions before teaching strategies to regulate and manage emotions. We have provided an overview of the most common strategies included in emotion regulation programs and important components of emotion regulation programs, including how to assess the suitability of a branded emotion regulation program. Amaze has produced a tipsheet for emotion regulation for Autistic teens. Monash University has produced a digital toolkit for young people with disability with a section on how to understand and manage their emotions including personalised downloadable resources.

There are also a number of manualised programs that have some evidence base for supporting children and adolescents in their social emotional awareness and/or enhance emotion regulation. These programs can be offered by suitably trained Aspect staff or external providers. These programs include the Secret Agent Society (SAS) and Westmead Feelings Program. The Zones of Regulation is a commonly used program, however as yet this approach lacks a solid evidence base. To begin to address this gap, ARCAP recently conducted an exploration of the use of the Zones in Aspect classrooms. The research report along with some guidelines for teachers are available to download for those teachers wanting to implement the Zones in their classrooms.

A positive Autistic identity is associated with better mental health and wellbeing among Autistic people. Conversely, masking and camouflaging (i.e. changing or concealing one’s natural personality in order to “fit in”) is associated with mental health challenges. It is important when working with Autistic people that any interventions or supports are aligned with the person’s authentic nature and preferences and aimed at building skills rather than trying to change or “normalise” them or their behaviour i.e. broadly speaking providing neuroaffirming care.