Adapted Visual Safety Plan for Autistic Youth (VSP-AY) to Address Self‑harm, Suicidal Ideation, and Suicide Behaviors: Protocol for a Pilot Randomized Controlled Trial.

This pilot randomized controlled trial will evaluate the Visual Safety Plan for Autistic Youth (VSP-AY) among 90 autistic youth aged 13-18 years randomly assigned to either the intervention group (treatment as usual plus VSP-AY) or control group (treatment as usual). The study focuses on two main objectives. First, it will assess the intervention's feasibility (successful implementation potential), usability (user-friendliness and intuitiveness), and acceptability (appropriateness and satisfaction levels). Second, it will evaluate the intervention's effectiveness in reducing depression symptoms, decreasing self-injurious behaviors and suicidal tendencies, compared to treatment as usual. Data will be collected from both perspectives, with adolescents and therapists completing assessment measures at baseline, post-intervention and one month post-intervention. The VSP-AY was developed through participatory research with autistic individuals, researchers, and designers, integrating visual adaptations, content modifications, and delivery guidance specifically tailored for autistic youth. This multi-informant approach will provide comprehensive insights into the intervention's feasibility and effectiveness, contributing to improved mental health support for autistic youth.