Examination of Built Environment Instruments Addressing Health Promoting Behaviors for People with Disabilities

Abstract

L’objectif de cette étude est de communiquer sur les contenus, la pertinence et l’impact d’un programme psychoéducatif en dix séances, à destination d’un public d’adultes venant de recevoir un diagnostic d’autisme et ne présentant pas de déficience intellectuelle. En effet, la survenue d’un diagnostic impacte fréquemment la qualité de vie de la personne concernée et augmente significativement les risques liés à l’anxiété et à la dépression. Une personne recevant un diagnostic d’autisme peut avoir l’impression de se sentir changée ou en difficulté pour intégrer ce diagnostic à la connaissance d’elle-même. Aussi, proposer une démarche psychoéducative en direction d’adultes avec autisme sans déficience intellectuelle devrait leur permettre d’accéder à une information fiable, personnalisée. De plus, la psychoéducation est déjà usitée dans bien des contextes où elle s’impose comme un outil d’autoanalyse et de pro-action face aux difficultés rencontrées par un individu, et ce, quel que soit le type de handicap ou de pathologie auquel il se trouve confronté. Un programme psychoéducatif de 10 séances individuelles a donc été développé, afin de proposer aux personnes concernées des outils fonctionnels et explicites pouvant leur permettre de mieux repérer et comprendre l’expression des particularités autistiques. Cet article présente les fondements théoriques, les objectifs et le contenu de ce programme.The objective of this study is to report on the content, relevance and impact of a ten-session psychoeducational program, aimed toward an audience of adults recently diagnosed with autism, without an intellectual disability. As a tool for developing knowledge and self-esteem, psychoeducation has positive effects on anxiety and depression, which can occur following a diagnosis (Bonsack et al., 2015). While psychoeducational programs for families of people with autism are beginning to emerge, there was no French-language program for adults with autism until then, even though a better understanding of their situation would benefit them (Arsenault et al., 2016). The program discussed here is the first one inspired by the third wave of behavioral and cognitive therapies; it is intended for adults with autism without intellectual disabilities. Launched in 2010, the development of this program takes into account both the heterogeneity of the expression of autistic disorder and the uniqueness of the individual profiles of the participants. The program's desired effect is to facilitate an individual's own understanding of situations and his/her relation to the environment. This involves providing access to scientifically valid, personalized, useful and understandable information that can foster the development and improvement of self-awareness, thoughts and beliefs (Mogensen et al., 2015). In order to be accessible and understandable, this program has been used for adults without intellectual disabilities. With a duration of 10 sessions, it is currently systematically offered as part of the Autism Resource Center Alsace-Adult Unit 68, attached to the Rouffach Hospital Centre. Any adult who has been diagnosed in this center is offered participation in the program. Currently, 80% of the patients treated were able to benefit from the program in a post-diagnostic intervention. In the form of individual interviews, the overall program includes a one-hour preliminary session, followed by nine sessions of 45-minutes each, divided according to the abilities of the persons concerned. Each session's content is presented on several types of media (physical or electronic) in order to facilitate understanding as well as to individualize the content. As the visual channel is generally the most functional in people with autism (Mottron, 2014), the participant can opt for a spoken interaction accompanied by a PowerPoint presentation, printed fact sheets or “homework” to handle each item. The topics covered during the sessions will include the diagnostic process, the characteristics and features of autism, preconceived ideas and stereotypes, functional and emotional aspects, identity and self-esteem. The dynamics of the interviews should stimulate verbal exchange about the person's feelings and experiences, as well as receiving and observing the participant's emotions. As of now, this program is a purely experimental initiative that does not yet meet international quality standard for social research. The implementation of such a psychoeducational program is geared towards the development – by those directly concerned – of knowledge about autistic syndrome and its inner workings. Impact is also expected on image, self-esteem, self-knowledge and quality of life. Indeed, studies on psychoeducational approaches that were completed generally demonstrate the stability and sustainability of their effects (Petitjean, 2011; Saout, 2008). Systematic pre- and post-intervention evaluation measures are being studied to verify the effectiveness of the program on elements such as anxiety, depression and the quality of life of those concerned.