Addressing the Needs of Diverse Youth with ASD and Anxiety in Public Schools: Stakeholder Input on Adaptations of Clinic-Based Facing Your Fears

Reaven, Judy; Reyes, Nuri; Pickard, Katherine; Tanda, Tanea; Morris, Megan A.

doi:10.1007/s12310-019-09351-z

Cited by 15 publications

(12 citation statements)

References 49 publications

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“…The AB met twice annually and provided input on FYF-SB, recruitment approaches, and strategies for dissemination. The AB also reviewed focus group data and provided input prior to a second round of focus groups (Reaven et al, 2019). This qualitative approach resulted in recommendations regarding the logistics/parameters of delivering FYF-SB in schools, suggestions for who should facilitate FYF-SB, which students should participate in the program, and how much caregiver involvement would be reasonable to request.…”

Section: Community Involvementmentioning

confidence: 99%

Implementing school-based cognitive behavior therapy for anxiety in students with autism or suspected autism via a train-the-trainer approach: Results from a clustered randomized trial

Reaven

Pickard

Meyer

et al. 2023

Autism

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Autistic youth frequently experience interfering anxiety, and schools may be an ideal setting to deliver mental health care. A type 1 hybrid-effectiveness, cluster randomized trial was used to examine the effectiveness of school-based Facing Your Fears compared to usual care. Change in provider cognitive behavior therapy knowledge and treatment fidelity (adherence and provider competence) were also examined. Seventy-seven interdisciplinary school providers across 25 elementary/middle schools were trained via a train-the-trainer approach. Eighty-one students, ages 8–14 years, with autism or suspected autism and anxiety participated. Students who received school-based Facing Your Fears displayed significantly greater reductions in anxiety compared to students in usual care according to caregiver and child report (Screen for Anxiety and Related Emotional Disorders). Significant reductions in total anxiety ( p = 0.012), separation ( p = 0.002), and social anxiety ( p = 0.003) subscales occurred, according to parent report. Student self-report indicated significant reductions on the social anxiety subscales ( p = 0.001). Interdisciplinary school providers demonstrated significantly increased cognitive behavior therapy knowledge following training ( p < 0.001). Mean adherence and competence ratings were strong. The positive effectiveness and implementation outcomes are encouraging. Training interdisciplinary school providers to deliver school-based Facing Your Fears has the potential to increase access to care for anxious autistic students. Future directions and limitations are discussed. Lay Abstract Autistic youth frequently experience anxiety that can negatively affect them at home, with friends, and at school. Autistic youth have difficulty accessing mental health care, and this is particularly true for youth from traditionally underserved backgrounds. Providing mental health programs in schools may increase access to care for autistic youth with anxiety. The purpose of the study was to train interdisciplinary school providers to deliver school-based Facing Your Fears, a cognitive behavior therapy program for anxiety in autistic youth. Seventy-seven interdisciplinary school providers across 25 elementary/middle schools were trained by their colleagues and members of the research (train-the-trainer approach). Eighty-one students with autism or suspected autism, ages 8–14 years, were randomly assigned to either school-based Facing Your Fears or usual care. Students in school-based Facing Your Fears showed significant reductions in anxiety compared to students in usual care according to caregiver and student report. Other measures involved examining change in provider cognitive behavior therapy knowledge after training and determining how well interdisciplinary school providers were able to deliver school-based Facing Your Fears. Results indicated that interdisciplinary school providers showed significant improvements in cognitive behavior therapy knowledge after training. Interdisciplinary school providers were able to deliver most of school-based Facing Your Fears activities and with good quality. The positive outcomes in this study are encouraging. Training interdisciplinary school providers to deliver school-based Facing Your Fears may increase access to care for anxious autistic students. Future directions and limitations are discussed.

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Section: Community Involvementmentioning

confidence: 99%

Implementing school-based cognitive behavior therapy for anxiety in students with autism or suspected autism via a train-the-trainer approach: Results from a clustered randomized trial

Reaven

Pickard

Meyer

et al. 2023

Autism

Self Cite

View full text Add to dashboard Cite

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“…For example, Luxford et al ( 2017 ) used the Exploring Feelings CBT to Manage Anxiety curriculum to teach students to understand and manage their emotions. In addition, a family- focused intervention, Facing Your Fears , has also been adapted for the school setting and incorporates parent educational sessions (Reaven et al, 2020 ).…”

Section: Aversive Strategies and Increased Focus On Positive Behavior Supports And Interventionmentioning

confidence: 99%

Educational Interventions for Children and Youth with Autism: A 40-Year Perspective

Odom

Hall

Morin

et al. 2021

J Autism Dev Disord

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Commemorating the 40 th anniversary of the Diagnostic and Statistical Manual (DSM) III, the purpose of this commentary is to describe school-based and school-relevant interventions and instructional approaches for children and youth with autism that have been developed and employed during that time period. The commentary begins with a brief description of foundational research that provides an historical context. Research themes shaped by science, ethics, social policy, and the changes in the DSM provide an organization for describing the evolution of intervention and instructional practices over the four previous decades. The commentary concludes with a discussion of school-contextual variables that influence implementation and the promise of the “iSciences” for closing the research to practice gap in the future.

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“…During Year 1, key stakeholders were engaged using an interactive round of focus groups with the goal to adapt the clinic version of FYF for diverse public school settings. This partnership and series of focus groups resulted in the adaptation of FYF to FYF-SB (Reaven et al, 2020). FYF-SB includes 12, 40-min sessions, 1 faceto-face session with caregivers, and group facilitators included interdisciplinary school providers.…”

Section: Project Timelinementioning

confidence: 99%

“…This study was part of a larger hybrid implementation trial that examined the effectiveness and preliminary implementation outcomes of a group CBT program for youth with ASD and anxiety (Facing Your Fears-School-Based; (FYF-SB) Reaven et al, 2020) implemented by interdisciplinary school providers within three diverse public school districts. Results from the randomized trial demonstrated that interdisciplinary school providers delivered FYF-SB with good fidelity and that students who received FYF-SB had significantly greater reductions in anxiety symptoms when compared to students receiving usual school mental health services .…”

Section: Introductionmentioning

confidence: 99%

Using evaluative frameworks to examine the implementation outcomes of a cognitive behavioral therapy program for autistic students with anxiety within public school settings

Pickard

Meyer

Reyes

et al. 2021

Autism

Self Cite

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Cognitive behavioral therapy for youth with autism spectrum disorder and anxiety is effective, but disparities exist in accessing these programs. Training school providers to deliver cognitive behavioral therapy may help to address these disparities. However, little is known about how cognitive behavioral therapy programs are implemented by interdisciplinary school providers and the broader impact of these programs. This study aimed to address this gap and was part of a larger trial that examined the effectiveness of Facing Your Fears–School-Based across 25 public schools. Study aims were to understand the impact of Facing Your Fears–School-Based and factors that impacted implementation. Thirty providers participated in exit interviews guided by the Reach, Effectiveness, Adoption, Implementation, and Maintenance framework. Primary themes included (1) the fit of Facing Your Fears–School-Based for diverse students; (2) the effects of Facing Your Fears–School-Based on students’ school participation; and (3) planned Facing Your Fears–School-Based maintenance. Participants also highlighted the program’s accessibility for non-mental health providers and reported adapting Facing Your Fears–School-Based in response to student needs. Results suggest that Facing Your Fears–School-Based may have a broader impact on students and highlight the importance of task sharing to overcome mental health staff shortages within public schools. Programs that can be implemented flexibly are also critical given variability in school structures and student needs. Lay abstract Cognitive behavioral therapy helps to treat anxiety symptoms in autistic youth, but it is difficult for families to access cognitive behavioral therapy in the community. Training school providers to deliver cognitive behavioral therapy may help autistic youth and their families to access these programs. Unfortunately, we do not know how cognitive behavioral therapy programs can be delivered by school providers and how these programs help the autistic students who access them. This study addressed this gap and was part of a larger study that looked at the effectiveness of Facing Your Fears–School-Based in 25 public schools. The study goals were to understand whether Facing Your Fears–School-Based helped students and the factors that made it easy or difficult to deliver Facing Your Fears–School-Based in schools. Thirty providers participated in interviews guided by the Reach, Effectiveness, Adoption, Implementation, and Maintenance framework. Participants shared information that fell into several major categories that included (1) delivering Facing Your Fears–School-Based to many different students; (2) the positive impact of Facing Your Fears–School-Based on students’ school participation; and (3) plans to continue using Facing Your Fears–School-Based. School providers also shared that Facing Your Fears–School-Based was easy to use for non-mental health providers and reported adapting Facing Your Fears–School-Based to meet student needs. The results of this study suggest that Facing Your Fears–School-Based may help autistic students and highlight the importance of using mental health programs in schools that are flexible, able to be adapted, and that are able to be used by many different types of school providers.

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Addressing the Needs of Diverse Youth with ASD and Anxiety in Public Schools: Stakeholder Input on Adaptations of Clinic-Based Facing Your Fears

Cited by 15 publications

References 49 publications

Implementing school-based cognitive behavior therapy for anxiety in students with autism or suspected autism via a train-the-trainer approach: Results from a clustered randomized trial

Implementing school-based cognitive behavior therapy for anxiety in students with autism or suspected autism via a train-the-trainer approach: Results from a clustered randomized trial

Educational Interventions for Children and Youth with Autism: A 40-Year Perspective

Using evaluative frameworks to examine the implementation outcomes of a cognitive behavioral therapy program for autistic students with anxiety within public school settings

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