Comparing Two Different Emotion Therapies for Autistic Youth and Young Adults

The Emotion Awareness and Skills Enhancement (EASE) Program Versus the Unified Protocol (UP)

Too few clinicians are able and willing to help autistic patients. A recent review identified challenges to mental health service delivery in autism, including a lack of interventions designed for community implementation and limited workforce capacity. It has been argued that improving impairment in emotion regulation has the potential to improve a range of mental health difficulties in autistic people. In this clinical trial, the investigators are comparing two evidence-based interventions for emotion regulation, to determine if one created specifically for autistic people is clinically superior. The interventions will be implemented in the community, through partnering agencies.

This study will compare the effectiveness of two transdiagnostic interventions for autistic adolescents and young adults - an intervention in widespread use among non-autistic populations (The Unified Protocol; UP) versus an autism-specific intervention (The Emotion Awareness and Skills Enhancement Program; EASE). The UP and EASE are ideal comparators because they are structurally equivalent and transdiagnostic - both shown to improve mental health outcomes that stakeholders identify as important, such as depression, irritability, and anxiety. The investigators will partner with 12 different community clinics in Pennsylvania and Alabama to recruit participants and facilitate the interventions. Each clinic will be randomized to use either UP or EASE. The investigators will look at effectiveness of the treatments, as well as the feasibility, benefits and harms.

Inclusion Criteria:

• professional diagnosis of ASD
• a score in the clinical range on the EDI-Reactivity or EDI-Dysphoria scale based on caregiver report or self-report
• The study is open to people with a range of communication abilities. Participants must be able to consent to the study themselves and answer questions about themselves.
• Participants need to have a support person that could answer questions about them too. This could be a parent, caregiver, family member, partner or friend. Independent adults can opt out of this portion.
• Participants must live in Alabama or Pennsylvania.

Exclusion Criteria:

- Higher level of care is needed (Imminent Suicide / Homicide Threat, acute psychosis, mania)