Narrative Family Therapy in Autism Spectrum: From Clinical Neuroscience to Intervention Outcomes
试验速览
- 阶段
- 不适用
- 状态
- 进行中（未招募）
- 入组人数
- 63
- 试验地点
- 1
- 主要终点
- Change from baseline to the post-intervention in the Systemic Clinical Outcome Routine Evaluation - 15 items (SCORE-15)
研究概览
简要总结
Autism Spectrum Disorder (ASD) is a neurodevelopmental condition characterized by difficulties in social communication and interaction, along with restricted and repetitive patterns of behavior, interests, or activities. While previous research has largely focused on individualized therapies and behavioral outcomes for people with autism, there remains a gap in understanding the broader effect on family systems functioning and the neurobiological changes that may occur following intervention.
This project aims to address that gap by characterizing families of individuals with autism, examining both individual and family-level variables, including their motivation to participate in Narrative Family Therapy. Participating families will be assigned to either an intervention group receiving Narrative Family Therapy or a control group engaged in a Game Theory-based approach (e.g., Stag Hunt Dilemma, Prisoner's Dilemma, War of the Sexes), designed to reflect family dynamics.
A mixed-methods approach will be employed to explore therapeutic changes across three key areas: (1) theory-of-mind brain networks, (2) narrative change, and (3) the overall well-being of family members reflected by the family functioning perceptions. Neurobiological data will be collected via functional Magnetic Resonance Imaging (fMRI) during an autobiographical, therapy-related task, conducted both before and after the intervention. This will be complemented by physiological measurements-including galvanic skin response (GSR), respiratory sinus arrhythmia (RSA), and heart rate variability (HRV)-to evaluate autonomic nervous system activity.
The investigators hypothesize that Narrative Family Therapy may promote neuroplasticity and restore effective connectivity within core brain circuits associated with social cognition, particularly the amygdala, ventromedial prefrontal cortex, and temporoparietal junction. Physiological data (GSR, HRV) collected during therapy sessions will also be analyzed to measure session-level effects. Specifically, the investigators will test whether autonomic arousal decreases across sessions and whether this reduction correlates with narrative development, assessed using the Assessment System of Narrative Change (ASNC) - a qualitative method based on empirical findings in Narrative Family Therapy.
To assess the feasibility and effectiveness of the therapeutic protocol, the Systemic Clinical Outcome and Routine Evaluation Scale (SCORE-15) and the Family Adaptability Cohesion Evaluation Scales IV Version (FACES-IV) will be administered. The investigators expect that the intervention will reduce mental health issues and enhance family functioning-such as communication, flexibility, and satisfaction-compared to the control group.
Overall, this study seeks to advance both scientific knowledge and clinical practice by fostering an innovative dialogue between Narrative Family Therapy and neuroscience.
研究设计
- 研究类型
- Interventional
- 分配方式
- Non Randomized
- 干预模型
- Parallel
- 主要目的
- Treatment
- 盲法
- Single (Participant)
入排标准
- 年龄范围
- 8 Years 至 18 Years（Child, Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Families of children, adolescents and/or young adults with ages ranging from 8 to 18 years;
- •Children, adolescents and/or young adults with a primary diagnosis of Autism Spectrum Disorder, verbally fluent, and without intellectual impairment (intelligence quotient above 70 as measured by the Wechsler Intelligence Scale for Children or Adults - 3rd Edition, WISC-III or WAIS-III).
- •Nuclear intact, divorced, large, and single-parent families.
排除标准
- •Participants with brain injury, alcoholism, drug abuse, active psychosis, homicidal/suicidal ideation, and personality disorder.
研究组 & 干预措施
Control Arm
The control group will receive a family-based intervention grounded in Game Theory.
干预措施: Family Game Theory-based Intervention (Behavioral)
Experimental Arm
The experimental group will receive Narrative Family Therapy for Autism Spectrum Disorder, a brief manualized intervention.
干预措施: Narrative Family Therapy (Behavioral)
结局指标
主要结局
Change from baseline to the post-intervention in the Systemic Clinical Outcome Routine Evaluation - 15 items (SCORE-15)
时间窗: From baseline to the end of treatment at 5 months.
次要结局
- Change from baseline to the post-intervention (5 months) and follow up (8 months later) in the Portuguese Family Communication and Family Cohesion - Version IV(From baseline to the end of treatment at 5 months, and to follow-up to 8 months (from baseline).)
- Assessment System of Narrative Change(At each intervention session from first to last (intervention last 5 months) and at follow-up (after 3 months from the last intervention session).)
- BOLD changes from baseline to the post intervention (5 months)(Assessments will be conducted within two weeks prior to the first intervention session and within two weeks following the end of the intervention (at five months).)
- The Satisfaction with Therapy and Therapist Scale-Revised adaptation after the follow-up (8 months)(After the follow-up session (8 months from baseline) within a month.)
- The long-term effect from pre-baseline (before intervention study enrollment) to the follow-up session on the Social Responsivness Scale- 16 items scores.(From pre-baseline (before the enrolment on the intervention study) to follow up within a month after the follow-up.)
- The long-term effect from pre-baseline (before intervention study enrollment) to the follow-up session on Brief Measure of Parental Wellbeing(From pre-baseline (before the enrolment on the intervention study) to follow up within a month after the follow-up.)
- The long-term effect from pre-baseline (before intervention study enrollment) to the follow-up session on Walsh Family Resilience Questionnaire(From pre-baseline (before the enrolment on the intervention study) to follow up within a month after the follow-up.)
- The long-term effect from pre-baseline (before intervention study enrollment) to the follow-up session on Coparenting Questionnaire(From pre-baseline (before the enrolment on the intervention study) to follow up within a month after the follow-up.)
- Skin Conductance Response(At each intervention session from first to last (intervention last 5 months) and at follow-up (after 3 months from the last intervention session)
研究者
Miguel Castelo-Branco
Full Professor
University of Coimbra