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

Abstract

This study examined the 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. 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 randomly allocated 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 active psychological intervention during this period. 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 maintained at the six-month follow-up. 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.