An Investigation into The Use of Play Therapy Principles as A Nondirective Therapeutic Approach for Autistic Adolescents

The intersection between autism and mental health has gained traction with researchers and health professionals in the last ten years. It is accepted that autistic individuals experience poor mental health at higher rates than their neurotypical peers and suggested that autistic adolescents (11-18-year-olds) may be more vulnerable to these challenges. In addition, COVID-19 has exacerbated mental health difficulties across populations but has disproportionately affected neurodivergent and SEND individuals. Despite this, the current therapeutic offer for autistic adolescents remains skewed towards behavioural interventions and parent support which negates the concept of autism as a spectrum condition. A systematic review by Casper et al. (2021) identified the potential of nondirective therapy for autistic adolescents and suggested Play Therapy guidelines (Axline, 1947) had potential for future research. This thesis presents a research design of mixed-methodologies across three phases and five studies that explore: 1) the current perceptions of therapeutic working with autistic adolescents from a therapist perspective, 2) the impact of COVID-19 on autistic adolescents’ mental health and therapeutic need and 3) the viability of a nondirective therapeutic intervention guided by play-therapy principles. The main findings identify an urgent need for training for therapists that is informed by autistic individuals, highlight the worsening state of mental health for autistic adolescents post-COVID-19 and suggest that a nondirective therapeutic approach informed by play therapy guidelines has potential to be beneficial in supporting adolescents’ mental health based on therapists’ experiences, autistic adolescents and trainee therapists’ perceptions. Together these findings indicate a crucial and time-sensitive need for further research that develops and assesses the efficacy of this nondirective approach as well as developing targeted training for therapists. This research addresses important gaps in knowledge that can be built upon with future co-created studies to meet the needs of the autistic community and support improved mental health and access to services for a vulnerable population of adolescents.