Therapeutic alliance in youth with autism spectrum disorder receiving cognitive-behavioral treatment for anxiety

Kerns, Connor M.; Collier, Amanda; Lewin, Adam B.; Storch, Eric A.

doi:10.1177/1362361316685556

Cited by 30 publications

(28 citation statements)

References 15 publications

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“…TA is seen as a fundamental component of effectiveness within other therapeutic approaches and has been demonstrated to be a significant predictor of treatment success (Holmqvist 2013; Horvath et al 2011; Lejuez et al 2006). Kerns et al (2018) concluded that a strong TA was related to more positive treatment outcomes in high-functioning children with autism. Similarly, the related concepts of “empathic teaching” in special education (Morgan 1991) and “rapport building” (Shireman et al 2016) and “compassionate care” (Taylor et al 2018) in behavior analytic treatment have been highlighted in efficacy literature as essential repertoires among service providers for individuals with disabilities.…”

mentioning

confidence: 99%

Behavioral Artistry: Examining the Relationship Between the Interpersonal Skills and Effective Practice Repertoires of Applied Behavior Analysis Practitioners

Callahan

Foxx

Swierczynski

et al. 2019

J Autism Dev Disord

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This study investigated interpersonal skills associated with the concept of behavioral artistry (BA), a repertoire of practitioner behaviors including care, attentiveness, and creativity, among others, associated with the effective delivery of applied behavior analysis (ABA) treatment. Survey results indicated parents of children with autism preferred BA descriptors for ABA therapists over non-BA descriptors. A separate survey of 212 university students on a standardized personality assessment revealed students majoring and/or working in the field of ABA had lower levels of BA than those in other human services professions. Practitioners with higher BA scores were observed and rated more positively in their delivery of ABA for children with autism. Implications for training/supervising effective ABA practitioners within a BA model are discussed.

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confidence: 99%

Behavioral Artistry: Examining the Relationship Between the Interpersonal Skills and Effective Practice Repertoires of Applied Behavior Analysis Practitioners

Callahan

Foxx

Swierczynski

et al. 2019

J Autism Dev Disord

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“…Parent reports of child externalizing problems, and clinician judgements of overall psychopathology, were associated with poorer task-collaboration in later sessions, but not to early therapeutic alliance or to late-session ratings of therapeutic bond. In the only other study of pre-treatment characteristics and alliance for children with autism, demographic factors and pre-treatment clinical levels of internalizing and externalizing symptoms were not related to post-treatment retrospective ratings of alliance, as reported by child, parent or therapist (Kerns et al, 2018). Beyond autism, associations of child factors and alliance are known to occur as a result of differences in source of reporting (e.g.…”

Section: Discussionmentioning

confidence: 90%

“…Few studies have looked at alliance in children with autism receiving psychotherapy. Kerns, Collier, Lewin, and Storch (2018) examined the relation between child- and therapist-reported alliance and treatment response in CBT designed to address anxiety in children and adolescents. Treatment responsive children were found to have greater post-treatment, retrospective therapist-rated (but not child-rated) levels of alliance than non-responsive children, with no link to child age or the severity of autism or internalizing and externalizing symptoms.…”

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confidence: 99%

Predictors and outcomes associated with therapeutic alliance in cognitive behaviour therapy for children with autism

Albaum

Tablon

Roudbarani

et al. 2019

Autism

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Therapeutic alliance is often an important aspect of psychotherapy, though it is rarely examined in clients with autism. This study aims to determine the child pre-treatment variables and treatment outcomes associated with early and late alliance in cognitive behaviour therapy targeting emotion regulation for children with autism. Data were collected from 48 children with autism who participated in a larger randomized-controlled trial. Pre-treatment child characteristics included child, parent, and clinician report of child emotional and behavioural functioning. Primary outcome measures included child and parent-reported emotion regulation. Therapeutic alliance (bond and task-collaboration) was measured using observational coding of early and late therapy sessions. Pre-treatment levels of child-reported emotion inhibition were associated with subsequent early and late bond. Pre-treatment levels of parent and child-reported emotion regulation were related to early and late task-collaboration. Late task-collaboration was also associated with pre-treatment levels of behavioural and emotional symptom severity. Task-collaboration in later sessions predicted improvements in parent-reported emotion regulation from pre- to post-therapy. Future research is needed to further examine the role of task-collaboration as a mechanism of treatment change in therapies for children with autism.

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“…Boswell et al (2012) explains the mixed findings in the literature by suggesting that readiness to change may be a moderator factor in treatment response, in that it may matter for those with very high degrees of clinical need, but less so for those with mild levels. It may also be that for children with autism, initial reported readiness may be less important than other process factors within therapy (Kerns et al, 2018), as the initial decision to embark in treatment may be better attributed to their parents’ motivation than their own (Fields et al, 2004).…”

Section: Discussionmentioning

confidence: 99%

Clinical and parental predictors of emotion regulation following cognitive behaviour therapy in children with autism

Tajik-Parvinchi

Farmus

Cribbie

et al. 2020

Autism

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Difficulties with emotion regulation are common in children with autism. Although interventions targeting emotion regulation show promise, children’s individual treatment responses vary, and it is important to understand the factors that contribute to treatment change. The present study aimed to identify pre-treatment child characteristics and parent psychopathology that predict treatment response in a 10-week manualized cognitive behaviour therapy intervention for children with autism, 8–12 years of age. Exploratory best-subset regression analyses were first carried out to identify the optimal set of predictors. Logistic regressions were then conducted to determine whether these variables predicted reliable improvement. Outcome variables consisted of the lability/negativity and the emotion regulation subscales of the Emotion Regulation Checklist. Predictors included pre-treatment developmental, clinical, and parent psychopathology variables. Analyses revealed that youth who started the treatment with higher verbal reasoning, higher impairment in social motivation, and more anxious parents were more likely to show reliable improvements in emotion regulation. Youth who started the treatment with higher internalizing scores had lower odds of showing reliable improvement. Implications of our findings include facilitation of active involvement, avoidance of complex language, and the provision of additional supports. Further suggestions to inform clinical practice are discussed. Lay abstract Children with autism commonly experience difficulty controlling their emotions. Although existing treatments are successful in teaching critical emotion regulation skills, not all children improve. It is important to identify the factors that influence treatment response to be able to reach more children. This study aimed to identify child and parent characteristics that predict treatment response in a 10-week cognitive behaviour therapy treatment for children with autism, 8–12 years of age, and their parents. We found that youth who started the treatment with higher verbal abilities, who were more anxious in social situations, and had parents who were more anxious, were more likely to improve in learning new emotion regulation skills. We also found that children who had more physical discomforts or complaints before starting the treatment were less likely to improve in their negative expressions of emotion. Our study suggests that it is important for clinicians to promote active involvement and learning by avoiding complex language and to use more visual materials to supplement the learning process, and make sure that sessions are sensitive to the individual needs of participants.

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Therapeutic alliance in youth with autism spectrum disorder receiving cognitive-behavioral treatment for anxiety

Cited by 30 publications

References 15 publications

Behavioral Artistry: Examining the Relationship Between the Interpersonal Skills and Effective Practice Repertoires of Applied Behavior Analysis Practitioners

Behavioral Artistry: Examining the Relationship Between the Interpersonal Skills and Effective Practice Repertoires of Applied Behavior Analysis Practitioners

Predictors and outcomes associated with therapeutic alliance in cognitive behaviour therapy for children with autism

Clinical and parental predictors of emotion regulation following cognitive behaviour therapy in children with autism

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