Up to 50% of autistic people experience co-occurring anxiety, which significantly impacts their quality of life. Consequently, developing new interventions (and/ or adapting existing ones) that improve anxiety has been indicated as a priority for clinical research and practice by the autistic community. Despite this, there are very few effective, evidence-based therapies available to autistic people that target anxiety; and those that are available (e.g., autism adapted Cognitive Behavioural Therapy; CBT) can be challenging to access. Thus, the current study will provide an early-stage proof of concept for the feasibility and acceptability of a novel app-based therapeutic approach that has been developed with, and adapted for, autistic people to support them in managing anxiety using UK National Institute for Health and Care Excellence (NICE) recommended adapted CBT approaches.

 The primary aim of this study is to establish the acceptability/ useability and feasibility of the app in a real-world clinic setting.

We also aim to establish the design of a future randomised-controlled trial of the app (e.g., the target population, performance of outcome measures and ideal timing/ duration of intervention).

Research Project Team:

• Dr Sophie Doswell
• Dr Antonia Dittner
• Mr Andrew Clarke
• Dr Ann Oszivadjian
• Dr Rachel Kent
• The Molehill Mountain Advisory Group

Research Funding:

• MRC Confidence in Concept award 2019 (1118148)

Participants are invited to engage with a self-guided app-based intervention. Primary (Generalised Anxiety Disorder Assessment, Hospital Anxiety and Depression Scale) and secondary outcomes (medication/ service use and Goal Attainment Scaling) are be assessed at baseline (Week 2 +/- 2), endpoint (Week 15 +/- 2) and three follow-ups (Weeks 24, 32 and 41 +/- 4). Participants are also be invited to complete an app acceptability survey/ interview at the study endpoint.

Feasibility study/ non-randomised (single-arm) pilot trial design.

Analyses will address app acceptability/ useability and feasibility (via survey/ interview and app usage data); and the design of a future full scale randomised controlled trial –both further informed by a dedicated stakeholder advisory group.

The evidence from this study will inform the future optimisation and implementation of an autism adapted app based anxiety intervention in a randomised-controlled trial, to provide a novel tool that can be accessed easily by autistic adults and may improve mental health outcomes.