The RCPsych Article of the Month for May is ‘The development of the Helping your Anxious Child programme: a parent-mediated group intervention for parents of autistic children in South Asia’ written by authors Caitlin Kittridge, Jacqui Rodgers et al and published in BJPsych International.

It is widely known that autistic children are frequently anxious. However, while a number of interventions exist in high-income countries, they remain scarce in South Asia.

The inspiration for this work began at an international meeting of the North East England South Asia Mental Health Alliance (NEESAMA.org) in Dhaka, Bangladesh, in 2019. During the meeting participants identified an unmet need for an intervention to support autistic children experiencing anxiety in South Asia. Over the next two years and following many early morning and late evening video calls, consultation with parents and several drafts of the materials the Helping your Anxious Child (HAC) programme was developed by a partnership of clinicians and researchers in Sri Lanka, Bangladesh and the UK.

This global collaboration highlighted the value of teamwork and the opportunity to listen to diverse perspectives, resulting in an intervention that we hope was culturally appropriate. Following the development of HAC parent groups took place in Bangladesh and Sri Lanka, facilitated by clinicians trained in the programme. The commitment of parents to attend the programme, even in the most challenging circumstances, was really apparent. For example, despite mile long queues at fuel stations and severe disruption to public transport amid the economic turmoil in Sri Lanka at that time parents managed to get to the group. Parents in Bangladesh shared with us that they thought the programme had increased their understanding of their child and they felt more empowered after attending. Parents also told us that they found the group format particularly helpful. Spending time with other parents in similar situations provided validation, social support and the opportunity to share strategies and made them realise that they are not alone in the challenges they face. This work is the first step on what we hope will be a long and fruitful collaboration between the UK and South Asia to continue to develop ways to support autistic children and their families.

Autism spectrum disorder (ASD) is an increasingly identified neurodevelopmental condition with significant impact on the lives of affected children, young people, and their families. It has been recognised that psychological interventions play a significant role in the management of mental health difficulties associated with ASD. This important paper describes the development of The Helping your Anxious Child (HAC) programme, a culturally tailored two-session skills-based group programme for parents, aiming to address anxiety issues in autistic children in Bangladesh and Sri Lanka. This programme has been based on evidence-based interventions with adaptations designed though co-production with clinicians, researchers, and local parents. It was made possible through collaborations via the North East England South Asia Mental Health Alliance, which seeks to bring together international partners in the UK and South East Asia to improve research, training and clinical service delivery. Preliminary findings support the feasibility, acceptability, and possible effectiveness of this intervention, and established the foundation of a larger trial.

Marinos Kyriakopoulos 

Editor-in-Chief, BJPsych International