Table 4.

Main themes and subthemes.

Main theme	Subtheme	Example quote
Misunderstanding autism and autistic traits	Pre-autism diagnosis	“When I was in hospital, I kept getting told off for walking on tip toes and for fidgeting a lot . . . they thought I was doing these things to burn more calories, except I’d been doing them for as long as I could remember.”
	Post-autism diagnosis	“I think the co-existence of [autism] as well as the eating disorder is something that just makes some adults teams feel, “It’s just too complicated, we just don’t really want to know”.”
One treatment does not fit all	Challenges of CBT	“With the CBT, maybe the problem is that they assume you have lot of these skills already . . . Therefore, I couldn’t even begin to make changes, because I don’t have any of those foundational skills.”
	Challenges of group therapy	“I’m largely silent in any sort of group situation because I don’t know what’s expected of me. I’m worried of saying the wrong thing or I worry about misinterpreting people.”
	Alternative therapeutic approaches	“DBT was really helpful . . . we spent a long, long time talking through emotions, identifying them and trying to think about how to regulate, how to manage them . . . DBT was about [emotion regulation] skills, and that was really important.”
Improving accessibility and engagement within services	Adapting communication styles	“It’s all about changing perceptions, it’s all about putting an autistic lens on and saying, how could I explain this differently?”
	Adapting service environments	“Noise . . . is something that has got to two patients and they’ve found that really difficult . . . we made allowances, in terms of music therapy taking place as far away from her as possible.”

CBT: cognitive behavioural therapy; DBT: dialectical behaviour therapy.