Reaven, J., Blakeley-Smith, A., Leuthe, E., Moody, E., & Hepburn, S. (January 01, 2012). Facing Your Fears in Adolescence: Cognitive-Behavioral Therapy for High-Functioning Autism Spectrum Disorders and Anxiety. Autism Research and Treatment, 2012, 2, 1-13.
Autism Spectrum Disorders (ASD) is an umbrella term representing a range of persistent cognitive deficits and impairments in communication and social interaction, often diagnosed by age two, and includes autistic disorder, Asperger’s syndrome, and pervasive developmental disorders. Children with ASD are at an elevated risk for developing anxiety disorders, which can become highly debilitating across environmental contexts (home, school, and social contexts). The results of previous research (case studies, small group studies, and randomized clinical trials) have provided evidence and support for the efficacy of modified CBT for youth with ASD and anxiety. In a 2012 study published in Autism Research and Treatment, researchers developed a modified version of a CBT intervention (“Facing Your Fears”) for adolescents with ASD, titled “Facing Your Fears: Group Therapy for Managing Anxiety in Children with High Functioning ASD” (FYF-A). They then assessed the feasibility and acceptability of the FYF-A intervention program. Participants included 24 adolescents and their families, age 13-18, with ASD and anxiety. They attended 14, 90-minute sessions, plus 1 booster session, which included large group activities with teens and parents, small-group activities with teens and parents alone, and dyadic work with parent and teen pairs. The program focused on core CBT components (including an introduction to anxiety symptoms and implementation of CBT strategies) and several modifications for teens with ASD. These modifications included: (1) a social skills module to address areas of social challenge; (2) parent-teen dyadic work focused on achieving a mutual understanding and shared goals; (3) the use of technology to both monitor symptoms of anxiety and remind participants to utilize CBT strategies; and (4) a parent curriculum. At post-treatment, participants showed significant reductions in anxiety severity and intrusiveness. These reductions were maintained at the 3-month follow up. Further, nearly half of the participants met criteria for a positive treatment response on primary diagnosis following the intervention. These finding are encouraging, as they add further evidence that modified CBT for adolescents with ASD is effective in decreasing anxiety symptoms among this group.