Debbie Spain1, Jacqueline Sin2, Eleni Paliokosta3, Marie Furuta4, Jonathan E Prunty5, Trudie Chalder6, Declan G Murphy7, Francesca G Happé1. 1. MRC Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, 16 de Crespigny Park, Denmark Hill, London, UK, SE5 8AF. 2. School of Psychology & Clinical Language Sciences, University of Reading, Earley Gate, Reading, UK, RG6 6AL. 3. Camden MOSAIC Child and Adolescent Mental Health Service and Social Communication Assessment Service, Tavistock & Portman NHS Foundation Trust, 120 Belsize Lane, London, UK, NW3 5BA. 4. Department of Human Health Sciences, Graduate School of Medicine, Kyoto University, 53 Kawara-cho,, Shogo-in, Sakyo-ku, Kyoto, Kyoto, Japan, 606-8507. 5. Institute of Psychiatry, Psychology & Neuroscience, King’s College London, Denmark Hill, London, UK, SE5 8AF. 6. Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, Weston Education Centre, Cutcombe Road, London, UK, SE5 9RH. 7. Sackler Institute for Translational Neurodevelopment, Institute of Psychiatry, Psychology & Neuroscience, King's College London, P50. Institute of Psychiatry, DeCrespigny Park, London, UK, SE5 8AF.
Abstract
BACKGROUND: Autism spectrum disorders (ASDs) are characterised by impairments in communication and reciprocal social interaction. These impairments can impact on relationships with family members, augment stress and frustration, and contribute to behaviours that can be described as challenging. Family members of individuals with ASD can experience high rates of carer stress and burden, and poor parental efficacy. While there is evidence to suggest that individuals with ASD and family members derive benefit from psychological interventions designed to reduce stress and mental health morbidity, and enhance coping, most studies to date have targeted the needs of either individuals with ASD, or family members. We wanted to examine whether family (systemic) therapy, aimed at enhancing communication, relationships or coping, is effective for individuals with ASD and their wider family network. OBJECTIVES: To evaluate the clinical effectiveness and acceptability of family therapy as a treatment to enhance communication or coping for individuals with ASD and their family members. If possible, we will also seek to establish the economic costs associated with family therapy for this clinical population. SEARCH METHODS: On 16 January 2017 we searched CENTRAL, MEDLINE, Embase, 10 other databases and three trials registers. We also handsearched reference lists of existing systematic reviews and contacted study authors in the field. SELECTION CRITERIA: Randomised controlled trials (RCTs) and quasi-RCTs investigating the effectiveness of family therapy for young people or adults with ASD or family members, or both, delivered via any modality and for an unspecified duration, compared with either standard care, a wait-list control, or an active intervention such as an alternative type of psychological therapy. DATA COLLECTION AND ANALYSIS: Two authors independently screened each title and abstract and all full-text reports retrieved. To enhance rigour, 25% of these were independently screened by a third author. MAIN RESULTS: The search yielded 4809 records. Of these, we retrieved 37 full-text reports for further scrutiny, which we subsequently excluded as they did not meet the review inclusion criteria, and identified one study awaiting classification. AUTHORS' CONCLUSIONS: Few studies have examined the effectiveness of family therapy for ASD, and none of these are RCTs. Further research studies employing methodologically robust trial designs are needed to establish whether family therapy interventions are clinically beneficial for enhancing communication, strengthening relationships, augmenting coping and reducing mental health morbidity for individuals with ASD and family members.
BACKGROUND:Autism spectrum disorders (ASDs) are characterised by impairments in communication and reciprocal social interaction. These impairments can impact on relationships with family members, augment stress and frustration, and contribute to behaviours that can be described as challenging. Family members of individuals with ASD can experience high rates of carer stress and burden, and poor parental efficacy. While there is evidence to suggest that individuals with ASD and family members derive benefit from psychological interventions designed to reduce stress and mental health morbidity, and enhance coping, most studies to date have targeted the needs of either individuals with ASD, or family members. We wanted to examine whether family (systemic) therapy, aimed at enhancing communication, relationships or coping, is effective for individuals with ASD and their wider family network. OBJECTIVES: To evaluate the clinical effectiveness and acceptability of family therapy as a treatment to enhance communication or coping for individuals with ASD and their family members. If possible, we will also seek to establish the economic costs associated with family therapy for this clinical population. SEARCH METHODS: On 16 January 2017 we searched CENTRAL, MEDLINE, Embase, 10 other databases and three trials registers. We also handsearched reference lists of existing systematic reviews and contacted study authors in the field. SELECTION CRITERIA: Randomised controlled trials (RCTs) and quasi-RCTs investigating the effectiveness of family therapy for young people or adults with ASD or family members, or both, delivered via any modality and for an unspecified duration, compared with either standard care, a wait-list control, or an active intervention such as an alternative type of psychological therapy. DATA COLLECTION AND ANALYSIS: Two authors independently screened each title and abstract and all full-text reports retrieved. To enhance rigour, 25% of these were independently screened by a third author. MAIN RESULTS: The search yielded 4809 records. Of these, we retrieved 37 full-text reports for further scrutiny, which we subsequently excluded as they did not meet the review inclusion criteria, and identified one study awaiting classification. AUTHORS' CONCLUSIONS: Few studies have examined the effectiveness of family therapy for ASD, and none of these are RCTs. Further research studies employing methodologically robust trial designs are needed to establish whether family therapy interventions are clinically beneficial for enhancing communication, strengthening relationships, augmenting coping and reducing mental health morbidity for individuals with ASD and family members.
Authors: John N Constantino; Sandra A Davis; Richard D Todd; Matthew K Schindler; Maggie M Gross; Susan L Brophy; Lisa M Metzger; Christiana S Shoushtari; Reagan Splinter; Wendy Reich Journal: J Autism Dev Disord Date: 2003-08
Authors: Mario Gálvez-Lara; Jorge Corpas; Eliana Moreno; José F Venceslá; Araceli Sánchez-Raya; Juan A Moriana Journal: Clin Child Fam Psychol Rev Date: 2018-09
Authors: Kasper Sipowicz; Tadeusz Pietras; Marlena Podlecka; Łukasz Mokros Journal: Int J Environ Res Public Health Date: 2022-03-04 Impact factor: 3.390