A Qualitative Study of Practitioner ExperiencesLow-intensity cognitive behavioural therapy (LICBT) services are a key component of mental health provision for children and young people in England. Given the elevated prevalence of mental health difficulties among autistic populations, these services are likely to receive referrals for autistic youth. However, evidence regarding the suitability of LICBT protocols for this group is limited, and little is known about practitioners’ experiences of supporting autistic youth. This study explored LICBT practitioners’ perspectives on working with autistic children and adolescents, including what helps prepare or support them in this work. Semi-structured interviews were conducted with Children’s Wellbeing Practitioners and Education Mental Health Practitioners working in LICBT services across England. Data were analysed using reflexive thematic analysis, informed by a critical realist epistemological stance. Two overarching themes were generated: (1) Delivering LICBT on Unstable Foundations, and (2) Navigating Organisational Challenges. Practitioners described feeling underprepared by core training and uncertain about the suitability of LICBT interventions for autistic youth. Successful intervention was perceived to depend on autism-specific adjustments and wider systemic support that were not always available. Organisational pressures, unclear role boundaries, and limited alternative service provision contributed to ethical discomfort and emotional strain. Many practitioners reported independently seeking additional training and informally extending their roles to bridge gaps in care. Findings highlight a misalignment between the LICBT service model and the realities of supporting autistic youth in practice. Addressing this requires strengthening the evidence for LICBT with autistic populations and closer integration between LICBT and autism-specific services to support equitable and appropriate care.
| Date of Award | 24 Jun 2026 |
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| Original language | English |
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| Awarding Institution | |
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| Supervisor | Ailsa Russell (Supervisor) & Maria Loades (Supervisor) |
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Doctorate in Clinical Psychology: Main Research Portfolio: 1) Adaptations to Effective Cognitive Behavioural Therapy for Autistic Children and Adolescents Since 2015: A Systematic Review with Intervention Development Mapping; 2) Evaluation of the Experiences and Needs of Children’s Wellbeing Practitioners and Education Mental Health Practitioners when Supporting Adolescents with Low Mood; 3) Supporting Autistic Children and Young People Within Low-Intensity CBT Services: A Qualitative Study of Practitioner Experiences
Cunningham, A. (Author). 24 Jun 2026
Student thesis: Doctoral Thesis › Doctor of Clinical Psychology (DClinPsy)