Psychological Interventions for Autistic Adolescents with Co-Occurring Anxiety and Depression: Considerations Linked to Autism Social Identity and Masking | Autism in Adulthood
Adolescence marks a time of increased vulnerability to developing mental health difficulties. Recent literature has pointed towards both risk and protective factors that contribute to the development and maintenance of co-occurring mental health difficulties amongst autistic adolescents. For example, autistic individuals may mask their autistic traits to fit in with neurotypical peers, but prolonged masking may negatively influence the development of one’s autistic identity and increase vulnerability to developing mental health difficulties. In this commentary, we focus our efforts on highlighting how 1) autistic identity and 2) masking behaviours may be considered within a holistic and person-centred formulation to guide treatment for mental health difficulties in autistic adolescents. In current clinical practice, mental health practitioners may not explicitly enquire about potential construct overlap between these autism related factors and other cognitive and behavioural factors that perpetuate mental health difficulties. We propose a series of assessment questions that clinical professionals may use when developing a shared understanding with autistic adolescents of how they perceive the relationship between autism and co-occurring mental health difficulties. Our goal is to support clinical professionals to consider ways of integrating advances in autistic identity and masking literature in autism to inform the assessment and formulation of co-occurring mental health difficulties when supporting autistic children and young people.
