Clinical effectiveness of an online psychoeducational and psychotherapeutic programme for caregivers of children newly diagnosed as autistic: a parallel, assessor-masked, randomised controlled trial in the UK (REACH-ASD)
Summary
This study published in The Lancet aimed to test the clinical effectiveness of the Empower-Autism programme plus treatment as usual versus the usual local post-diagnostic psychoeducation offer plus treatment as usual on caregiver mental health at the 52-week follow-up. The Empower-Autism programme showed a sustained moderate positive effect on caregiver mental health at the 12-week, 26-week, and 52-week post-baseline follow-ups, compared with treatment as usual alone. It was also associated with clear improvements in caregiver wellbeing, autism knowledge, adjustment to the diagnosis, and family wellbeing across 12 months.
View The Lancet article View the feasibility study Empower-Autism supplementary materials
Findings
- 835 potential participants were referred and screened, 384 provided consent, and 379 caregivers were recruited, 255 of whom were randomly assigned to the intervention group and 124 to the treatment as usual group.
- Participants randomly assigned to Empower-Autism had improved mental health at 52 weeks compared with those randomly assigned to treatment as usual.
- The programme improved caregiver adjustment to the diagnosis, caregiver autism knowledge, and family wellbeing at 12 months, but it did not significantly affect parenting stress and self-efficacy or child-focused outcomes.
- The most common adverse events concerned significant deteriorations in the mental health of caregiver participants or index children and other serious personal issues potentially affecting caregiver mental health.
Recommendations
This study recommends the inclusion of the remotely delivered Empower-Autism programme as part of an integrated stepped-care pathway for families and caregivers of autistic children.
- Incorporate ACT and psychoeducation: Use acceptance and commitment therapy (ACT) techniques to improve caregiver psychological flexibility and resilience, alongside tailored autism psychoeducation to enhance understanding and adjustment.
- Prioritise caregiver mental health: Regularly assess caregiver wellbeing and provide targeted support or referrals to address mental health challenges, recognising their critical role in family dynamics and care.
- Facilitate accessible group-based interventions: Offer remote or in-person group sessions to reduce caregiver isolation, provide peer support, and deliver practical strategies for managing caregiving complexities.
Reference
Kathy Leadbitter, Sophie Langhorne, Richard Smallman, Petrina Chu, Ceri Ellis, Louisa Harrison, Tessa Hutton, Charlotte Butter, Caitlin Goldie, Kirsty James, Latha Hackett, Alison Dunkerley, Penny Bee, Gemma Shields, Linda Davies, Richard Emsley, Jonathan Green, and the REACH-ASD Team https://www.thelancet.com/journals/lanpsy/article/PIIS2215-0366(25)00036-7/fulltext
