A Pilot Study of Family-Based Exposure-Focused Treatment for Youth with Autism Spectrum Disorder and Anxiety

Storch, Eric A.; Schneider, Sophie C.; Nadai, Alessandro S. De; Selles, Robert R.; McBride, Nicole M.; Grebe, Stacey C.; Bergez, Katherine C.; Ramírez, Ana C.; Viana, Andres G.; Lewin, Adam B.

doi:10.1007/s10578-019-00923-3

Cited by 20 publications

(29 citation statements)

References 66 publications

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“…Alongside these "functional" modes of treatment, it is broadly recognized that the emotional aspects of the autistic condition call for psychotherapy, and various modes of "emotional" therapy focus on the inner reality of the child, the development of the self, the child's attempts to express him/herself, his/her anxieties, inhibitions, defenses, and the way in which she/he perceives and experiences the world. Most of the research on ASD relates to psychotherapies, such as personal construct theories, family-focused therapy, and cognitive behavioral therapy (CBT; Hare, 1997;Cardaciotto and Herbert, 2004;Wood et al, 2015;Murphy et al, 2017;Storch et al, 2020). CBT takes center stage in research with ASD and numerous randomized controlled trials (RCTs) have shown that it is effective for treating anxiety disorders in adults, adolescents, and in children diagnosed with ASD (Sukhodolsky et al, 2013;Hesselmark et al, 2014;Vasa et al, 2014;Spain et al, 2015;Wood et al, 2015).…”

Section: Dir -A Developmental Approach Developed By Stanleymentioning

confidence: 99%

The “Muscles of the Psyche”: From Body Literacy to Emotional Literacy

Vulcan

2021

Front. Psychol.

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Autism spectrum disorder (ASD) is a neuro-developmental condition, which requires a multi-disciplinary matrix of treatments, including functional, educational, and emotional interventions. The latter mode of treatment entails particular difficulties, inasmuch as the core deficits of this condition seem to challenge the very premises of traditional psychotherapy. Reciprocity, verbal, and symbolic expression and inter-subjective dynamics are often difficult to attain with clients diagnosed with ASD, and emotional treatment thus often turns out to be a frustrating process, which may well elicit questions as to the efficacy of psychotherapeutic emotional interventions. These core challenges, described in the literature, become particularly acute in view of the increasing number of clients diagnosed on the autistic spectrum in recent years, and the growing need for qualified therapists who have trained for working specifically with this condition. It seems, therefore, that it is high time for systematic research into the lived experience of therapists working with these clients in order to attain a better clinical and theoretical understanding of the condition itself and broaden the range of effective interventions. This study, informed by a phenomenological-hermeneutic approach which guided both the collection of data and its subsequent analysis, aims to address these issues by exploring the particular challenges faced by therapists in this field, the questions that come up in the process, modes of personal and professional coping, and the insights elicited by the therapeutic encounter. The research consisted of in-depth interviews with 28 practicing therapists from a broad range of clinical orientations, including dance/movement, arts, music, and drama therapists, clinical psychologists, and clinical social workers. The essential themes that emerged from the participants’ responses and the analysis of the findings lend support to theoretical and developmental approaches, which focus on the primacy and the foundational role of the concrete body in inter-subjective relationships and in the therapeutic process, and indicate the potential efficacy of somatic and kinetic interventions. The clinical implications of this study are thus highly relevant to the training and support of therapists working with ASD, who should be encouraged to develop greater receptivity to non-verbal modes of interaction in the therapeutic process.

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Section: Dir -A Developmental Approach Developed By Stanleymentioning

confidence: 99%

The “Muscles of the Psyche”: From Body Literacy to Emotional Literacy

Vulcan

2021

Front. Psychol.

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“…Those who do not demonstrate an adequate response to PLTA are ''stepped up'' to standard CBT, which consists of 10 therapist-led, parent-supported sessions, each lasting 60 minutes over the course of 12 weeks, following either the Cool Kids ASD Adaptation (for youth ages 6-14 years) or the Family-Based Exposure-Focused Treatment manual (for youth ages 4-5 years). 21,59 After completing the standard CBT phase, participants complete treatment and undergo a post-treatment assessment. In order to maintain consistency with procedures in the standard CBT phase, participants in the maintenance phase (i.e., responders to PLTA) complete the post-treatment assessment approximately 12 weeks after the completion of the mid-treatment assessment.…”

Section: Overviewmentioning

confidence: 99%

“…For youth aged 4-5 years, the Exposure-Focused, Family-Based CBT for Youth with ASD and Comorbid Anxiety manual (FET) is used. 21 The FET protocol also consists of 10 sessions, each 60 minutes long, with both the parent and youth present. Each session includes a statement of session goals, a review of the preceding week's at-home tasks, and graduated therapist assistance with session activities, including in-session exposures, home tasks for the coming week, and monitoring procedures.…”

Section: Standard Cbt: Cool Kids and Fetmentioning

confidence: 99%

“…20 More recent studies have provided further support for CBT in small samples. 21,22 Further, findings from a large randomized trial (n=167) using ASD-adapted CBT for youth indicated that personalized CBT (addressing social communication, self-regulation, and behavioral challenges) was superior to standard CBT, both of which were superior to treatment as usual. 19 Although there is good evidence supporting CBT for anxiety in youth with HFA, there are significant barriers to accessing treatment.…”

Section: Introductionmentioning

confidence: 99%

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Parent-led, stepped-care cognitive-behavioral therapy for youth with autism and co-occurring anxiety: study rationale and method

Ramírez

Grebe

McNeel

et al. 2020

Braz. J. Psychiatry

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Anxiety disorders affect up to 50% of individuals with autism spectrum disorder (ASD) and are significantly impairing to the person affected, as well as to their loved ones. Cognitive-behavioral therapy (CBT) has been established as the gold-standard treatment for anxiety disorders among typically developing youth and adults, and demonstrates similar efficacy among youth with high-functioning autism (HFA). Many CBT interventions utilize a “full-package” treatment approach to treat co-occurring anxiety in youth with ASD. However, these service delivery systems are often therapist-intensive, costly, and impractical, thereby compromising full engagement and treatment adherence. This paper describes the design, rationale, and methodology of a study examining stepped-care CBT for youth with HFA and co-occurring anxiety – a clinical trial examining the efficacy of low-intensity, parent-led CBT as the first line of treatment and utilizing a more intensive, therapist-led intervention for nonresponders. The study will evaluate the potential benefits of stepped-care and parent-led therapist-assisted interventions, predictors of treatment response, and the economic value of using a stepped-care model. Implications for practice will be discussed.

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“…According to Storch et al (2020), anxiety is frequently encountered in young people with autism spectrum disorders. The use of behavioural cognitive therapy is recommended for treating this population; however, available treatment protocols may be difficult to implement outside of research settings.…”

Section: Topic Addressedmentioning

confidence: 99%

Intervention Models for The Pre-Integration of Children with ASD in Mainstream Education

Ivan

Ciolcă

Dreve

2020

BRAIN

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The pathology of autism dates back to the 1900s, being framed within the broad sphere of neuropsychological conditions. So far, the autism spectrum disorder (ASD) has passed through various pathologies, from socio-emotional disorders to schizophrenic disorders. The clear distinction between childhood autism and childhood schizophrenia was only made in the early 1980s. ASD is one of the most common invasive developmental disorders; defined as a neurological condition characterised by a distortion in the overall development of a person, it affects 1 in 150 children and 4 to 5 boys per girl. The autistic triad brings together qualitative anomalies in social interactions (in verbal and nonverbal communication), restricted interests and stereotypes. The 1980s and 1990s highlight the role of behavioural therapy and the use of highly controlled learning environments as a primary treatment for the forms of autism and related conditions. Promising studies on the role of oxytocin or certain amino acids involved in neurotransmission, especially in regulating stress and its emotional consequences, are currently in progress. Until now, the two therapies have remained primordial along with physical therapy and speech therapy. The purpose of this paper is to present some of the means that can contribute to the pre-integration of children in mainstream education, being also a starting point for future applied research. At the same time, the paper is helpful for the parents of children with ASD, who are given the opportunity to work themselves in the absence of a specialist or financial possibilities.

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A Pilot Study of Family-Based Exposure-Focused Treatment for Youth with Autism Spectrum Disorder and Anxiety

Cited by 20 publications

References 66 publications

The “Muscles of the Psyche”: From Body Literacy to Emotional Literacy

The “Muscles of the Psyche”: From Body Literacy to Emotional Literacy

Parent-led, stepped-care cognitive-behavioral therapy for youth with autism and co-occurring anxiety: study rationale and method

Intervention Models for The Pre-Integration of Children with ASD in Mainstream Education

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