The Effectiveness of an Integrated Emotion-Focused Therapy and Music Therapy Package in Reducing Stress, Anxiety, and Depression among Adults with High-Functioning Autism Spectrum Disorder
Keywords:
autism spectrum disorder, high-functioning autismhigh-functioning autism, emotion-focused therapy, music therapy, stress, anxiety, depressionAbstract
This study examined the preliminary effectiveness of an integrated therapeutic package combining emotion-focused therapy and music therapy in reducing stress, anxiety, and depression among adults with high-functioning autism spectrum disorder. A quasi-experimental pretest-posttest-follow-up design with a control group was used; after purposive eligibility screening, participants were allocated to groups using a simple random procedure. The population consisted of adults aged 18-45 years with autism spectrum disorder level 1, without intellectual disability, who attended psychological centers and private or semi-private clinics in Tehran, Iran, in 2025. Thirty adults were screened, and 27 eligible participants were selected through purposive sampling and allocated by simple random procedure to an experimental group (n = 14) or a control group (n = 13). The experimental group received 12 sessions of the integrated intervention over six weeks, with two 90-minute sessions per week; the control group received no study-delivered active psychological intervention during this period, while access to stable usual care was not restricted. Outcomes were measured using the Depression Anxiety Stress Scales-21 (DASS-21). Mixed-design repeated-measures analyses of variance showed significant time × group interactions for stress, F(1.018, 25.447) = 77.285, p < .001, partial eta squared = .756; anxiety, F(1.007, 25.177) = 24.007, p < .001, partial eta squared = .490; and depression, F(1.011, 25.277) = 35.964, p < .001, partial eta squared = .590. The experimental group showed substantial reductions from pretest to posttest, and these gains were observed at the six-month follow-up, although maintenance should be interpreted cautiously because treatments received during follow-up were not experimentally controlled. The findings suggest that an integrated emotion-focused and music-based intervention may be a useful structured approach for reducing internalizing symptoms in adults with high-functioning autism spectrum disorder.
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