Feasibility of BeatIt-Aut: Behavioral Activation Therapy Adapted for the Treatment of Depression in Autistic Adults

• We evaluated an adapted behavioral activation protocol, BeatIt-Aut, for 13 autistic adults with depression. • All participants completed the treatment and post-intervention evaluations. • Feedback was generally positive, though more variable for adults without a supporter. • Some clinical improvements were reported by both autistic adults and their supporters. • Findings support further research to evaluate BeatIt-Aut for treatment of depression in autistic adults. Behavioral activation (BA) is well-established for treating depression in the general population. Despite suggestions that elements of BA (e.g., structure, clear goals, and focus on value-guided and goal-directed behaviors) may be well-suited for autistic people, there remains a gap in research exploring the use of BA to treat depression in autistic adults. BeatIt, a BA program originally adapted for adults with mild-to-moderate intellectual disabilities (ID), provides a compelling starting point, as it already includes modifications suggested for autistic adults. The current study aimed to evaluate the feasibility, acceptability, and preliminary outcomes of BeatIt-Aut, an adaptation of BeatIt for use with autistic adults with and without ID. BeatIt-Aut implemented minor adaptations following feedback from focus groups and in-depth review by two autistic adults. Participant and Supporter feedback was generally positive. Acceptability was more variable for adults without Supporters (n=5). Preliminary feasibility and clinical data support further study of BeatIt-Aut to treat depression in autistic adults, though community psychoeducation regarding depression and its treatment may be warranted to support recruitment of autistic adults with co-occurring ID. Further research is needed to explore how best to determine if behavioral activation with or without a supporter is the most appropriate approach for an individual.