Autistic adults who took part in an adapted group-based programme in mindfulness-based stress reduction (MBSR) reported reduced stress and improved ability to cope with everyday challenges. These findings come from a new study from Karolinska Institutet, published in Autism in Adulthood.
Stress as an everyday challenge
High levels of stress are common among autistic adults. The causes may include sensory overload, social demands, financial difficulties or uncertainty around changes in routine. While MBSR has shown beneficial effects in several groups, there has been limited research on its impact among autistic adults.
Tatja Hirvikoski , associate professor at the Department of Women's and Children's Health and research group leader at KIND ( Center of Neurodevelopmental Disorders at Karolinska Institutet ), explains:
"Many autistic adults feel uncertain about whether they will be able to cope with everyday stressors, especially when things do not go as planned, change suddenly or become overwhelming. We wanted to investigate whether mindfulness-based stress reduction could be an effective and safe way to reduce stress."
Group intervention adapted for autistic participants
The study included 77 autistic adults who were randomly assigned to either an eight‑week MBSR programme or regular care. The programme was delivered in groups of autistic participants only and included mindfulness exercises such as breathing practices and body scans, as well as reflections on reactions to stressful situations. The intervention was adapted according to participants' needs, using clear instructions, predictable routines and a low‑sensory environment. The teachers had experience working with autistic adults and formal training in MBSR in line with international standards.
Participants in the MBSR group reported a greater reduction in stress compared with those receiving regular care. Many also felt better equipped to handle everyday situations that had previously caused difficulties. Symptoms of anxiety and depression decreased more in the MBSR group as well.
A new approach to stress
Qualitative analyses showed that the group setting was important for participants' experience of the programme. Since all participants were autistic, many described the environment as safe and socially inclusive. Several emphasised the value of concrete, practical exercises rather than theoretical material.
"Practising mindfulness is not always easy, but participants appreciated the clarity, the group's sense of safety and that the programme offered more than a technique - it offered a new way of relating to stress," says Tatja Hirvikoski.
Many participants described gaining a new understanding of their thoughts and reactions, noting that mindfulness helped them view their responses in a more nuanced and less judgmental way. At the same time, several expressed uncertainty about maintaining the exercises after the programme ended, which the researchers highlight as an important area for future investigation.
The research group is now developing an internet-based mindfulness programme, I‑Mindfulness, to evaluate whether similar effects can be achieved in a digital format.
Publication
Hirvikoski, T., et al. (2025). Mindfulness-based stress reduction for autistic adults in outpatient care: A randomized controlled effectiveness trial . Autism in Adulthood. https://doi.org/10.1177/25739581251400582
The study was funded by ALF funds from Region Stockholm and the Promobilia Foundation.
