The feasibility and acceptability of delivering virtual reality cognitive behaviour therapy for anxiety experienced by autistic young people
Autism
This is a feasibility study, due to the novel intervention, it is an initial development and feasibility investigation. Due to the feasibility stage, it will have a limited sample size (10-25 participants). As this is a newly developed intervention, there will be an initial development phase, where the virtual reality intervention is developed from a research literature review and service user feedback. Once the intervention is developed, recruitment will begin. As it is a novel intervention, the focus is on pre- and post-intervention testing, with no double-blind or control group. Participants will be community-based patients aged between 12-18 years who have significant autistic traits as assessed by the Autism Quotient (AQ) questionnaire and significant anxiety as assessed by the Anxiety Scale for Children with ASD (ASC-ASD) and the Liebowitz Social Anxiety Scale (LSAS) for Children and Adolescents. TRIAL SETTING & RECRUITMENT The trial will be conducted at one centre, CAMHS North (Saffron Ground, HPFT, Stevenage) with clinicians with experience in assessing mental health difficulties in autistic young people. Participants will be identified for screening from initial assessments at these clinics, which are part of their routine care. Participants will not be recruited into the study through assertive outreach. The trial will be offered Virtual Reality intervention for anxiety as part of the care options for the clinics. The research team are located in the clinic, so the referrals can be made in person to the research team. The research team will regularly update the clinics via team meetings to encourage referrals. In considering current referral rates and reasons for referrals, it is estimated that there will be 15 eligible referrals per month. At this stage, it is unknown what recruitment rates will be, however, within the autistic population there have been requests and interest in virtual reality treatment. Recruitment will also be limited by the numb
1. Community-based service users, aged 12-18 years 2. Significant autistic traits as assessed by a score of 32-50 on the Autism Quotient (AQ) questionnaire (indicates a strong likelihood of ASD) 3. Significant anxiety as assessed by a total score of 20 or above on the Anxiety Scale for Children with ASD (ASC-ASD) and a score of 30 or above on the Liebowitz Social Anxiety Scale (30-49 indicates mild social anxiety) 4. Ongoing medication (SSRI, tricyclic antidepressant, antipsychotic, benzodiazepine) is allowed as long as the dose is kept stable for a sustained period before (>=6 weeks)
1. Score on the Visually Induced Motion Sickness Susceptibility Questionnaire (VIM SSQ), that is one standard deviation above the mean total score will be advised not to take part in the study (Mean Score Females, 29.23 Standard Deviation 19.05; Mean Score Males 11.36, Standard Deviation 7.76) 2. History of psychotic disorder (psychotic symptoms, bipolar disorder) 3. Alcohol/substance abuse disorders within the past 12 months 4. Any other DSM-5 disorder that is considered the primary focus of treatment 5. Actively planning suicide as judged by the clinician to be at significant risk of acts of suicide 6. Received Virtual Reality Treatment in the last 6 months 7. CBT is not allowed during or within 6 weeks of the start of the intervention 8. Regular psychotropic drugs use other than permitted medication 9. Currently involved in a treatment research study 10. Epilepsy or other clinically defined neurological disorder or insult 11. Currently receiving specialist care for any vision-related difficulties (e.g. double vision) 12. Experience of severe migraines 13. Inadequate understanding of English to give informed consent or such that the outcome measurement is not possible