Training clinicians to deliver group CBT to manage anxiety in youth with ASD: Results of a multisite trial.

Reaven, Judy; Moody, Eric J.; Klinger, Laura Grofer; Keefer, Amy; Duncan, Amie; O’Kelley, Sarah; Meyer, Allison; Hepburn, Susan; Blakeley‐Smith, Audrey

doi:10.1037/ccp0000285

Cited by 29 publications

(34 citation statements)

References 44 publications

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“…CBTs were previously reported as useful in improving functioning among typically developing students with social phobia [Tillfors et al, ]. Recent randomized controlled studies have also indicated positive effects of CBT on reduction of anxiety symptoms among individuals with ASD [Murphy et al, ; Reaven et al, ; Wise et al, ]. However, most of these studies were conducted with children or adolescents, focused on reduction of different kinds of anxiety, and used generic CBT protocols not specifically designed for treatment of social anxiety.…”

Section: Discussionmentioning

confidence: 99%

“…In some cases, high levels of social anxiety symptoms may result in a diagnosis of social anxiety disorder (SAD), also known as social phobia [Diagnostic and Statistical Manual of Mental Disorders (DSM‐5), APA, ]. Although the high prevalence of anxiety disorders among individuals with ASD has led to studies utilizing cognitive behavioral therapy [CBT; Murphy et al, ; Reaven et al, ; Wise et al, ], most have been conducted with children or adolescents, and have used general CBT protocols not specifically designed for addressing social anxiety. As social anxiety may significantly affect the ability to adapt to everyday independent functioning among students without and with ASD [Kraper, Kenworthy, Popal, Martin, & Wallance, ], remedying this gap in adult ASD research is necessary.…”

Section: Introductionmentioning

confidence: 99%

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Diametrically opposed associations between academic achievement and social anxiety among university students with and without autism spectrum disorder

2019

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Research findings indicate that anxiety, social anxiety in particular, is the most common experience reported by individuals with autism spectrum disorder (ASD) attending postsecondary education. Among students without ASD, higher levels of social anxiety have been postulated to correlate with impaired academic achievement; restriction of one's social network because of anxiety is thought to lead to reduction of access to resources important for learning such as social/emotional support and collaborative learning. However, despite growing interest in the outcomes of young students with ASD, no research has studied the associations between academic achievement and anxiety among students with ASD. This study examined the association between social anxiety and grade point average (GPA) among university students: 55 diagnosed with ASD, 31 without ASD but high levels of social anxiety, and 25 without ASD and with low levels of social anxiety (controls). GPAs were significantly lower for the ASD group than for the two non-ASD groups. Among students without ASD, a negative correlation between social anxiety and grades was observed whereas the reverse pattern was found for the ASD group, meaning that for students with ASD, higher levels of social anxiety were associated with higher grades. Additionally, in a regression analysis, ASD diagnosis, social anxiety, and the interaction of group × social anxiety significantly predicted GPA. Possible explanations for this finding, as well as implications for interventions among this population of high-functioning students with ASD, are discussed.Lay Summary: This study compared the relationship between levels of social anxiety and grades in students with autism spectrum disorder (ASD) and in students without ASD who had either high social anxiety or low social anxiety (controls). Among the group with ASD, higher levels of social anxiety were associated with higher grades, whereas the reverse pattern was found among the other groups. This finding's implications for interventions among students with ASD are discussed.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Diametrically opposed associations between academic achievement and social anxiety among university students with and without autism spectrum disorder

2019

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“…The strategies presented in the didactics were chosen from the National Clearinghouse on Autism Evidence and Practice (NCAEP) report on evidence-based practices (Steinbrenner et al, 2020) and included strategies such as visual supports, video modeling, and social narratives that are supported by the current intervention literature (e.g. see Reaven et al, 2018, for a discussion of how to provide community training for mental health clinicians to tailor CBT for autistic clients).…”

Section: Echo Autism Mental Health Modelmentioning

confidence: 99%

Mental health Project ECHO Autism: Increasing access to community mental health services for autistic individuals

Dreiling

Cook

Lamarche

et al. 2021

Autism

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Despite the high prevalence of co-occurring autism spectrum disorders and mental health condition(s), there exist substantial barriers to mental health treatment for autistic individuals. These barriers are exacerbated by a lack of mental health provider training and self-efficacy in providing adapted services to autistic individuals. One method which has been effective in mitigating similar service gaps is the Extension for Community Healthcare Outcomes (Project ECHO) Autism model, a tele-mentoring platform that connects primary care physicians to autism spectrum disorder experts to improve physicians’ knowledge, self-efficacy, and practice. This study developed and implemented a pilot mental health version of Project ECHO Autism designed to increase mental health provider knowledge, self-efficacy, and problem-solving. Community mental health providers ( N = 51) participated in the 6-month Project ECHO Autism including mental health–focused didactics and provider case presentations. Analysis of pre- and post-measures revealed improvements in all domains, including significant increases in provider knowledge of autism spectrum disorders, self-efficacy, and problem-solving. Participants additionally reported high satisfaction with their experience. Taken together, preliminary results indicate that Project ECHO Autism may be a feasible, accessible, and effective method for increasing mental health provider competence and ultimately increasing access to services for autistic individuals who have co-occurring mental health diagnoses. Lay abstract Although many autistic individuals have additional mental health conditions, most have a hard time getting services from mental health providers. One reason why these services can be hard to access is that many mental health providers do not feel confident in their ability to provide services to autistic individuals. To share autism expertise with local community providers and boost their confidence in working with autistic individuals, we created a mental health version of the Extension for Community Healthcare Outcomes (Project ECHO) Autism virtual teleconsultation program. In this pilot study, we recruited 51 community mental health providers to participate in Project ECHO Autism. During each biweekly session, providers received information from autism experts about how to tailor mental health interventions (e.g. attention-deficit hyperactivity disorder or anxiety interventions) for use with autistic individuals. They also had the opportunity to ask questions and get advice on their current cases. At the end of the 6-month study, mental health providers showed improvements in their confidence, in their knowledge of autism, and in their problem-solving skills. Nearly half (45%) of these providers participated from rural counties, suggesting that the Project ECHO Autism teleconsultation model was able to reach mental health providers who might not have been able to get training otherwise. This study supports the feasibility of using Project ECHO Autism to share autism knowledge with mental health providers, consequently expanding mental health service options for autistic individuals with co-occurring mental health conditions.

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“…Further explication of such mechanisms is critical for effective treatment planning. There has been a proliferation of intervention studies targeting anxiety in autism over recent years with evidence for efficacy for standard and modified CBT approaches (Kerns et al, 2016; Reaven et al, 2018; Wood et al, 2015). Recent data emphasize the need for specific attention to IU, including evidence of IU as a predictor of effectiveness for anxiety treatment (Keefer et al, 2017; Rodgers et al, 2016a; Rodgers et al, 2016b).…”

Section: Discussionmentioning

confidence: 99%

“Intolerance of uncertainty” mediates the relationship between social profile and anxiety in both Williams syndrome and autism

et al. 2021

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Anxiety is the most significant mental health concern for both Williams syndrome (WS) and autism. Whilst WS and autism are characterized by some syndrome‐specific social differences, less is known about cross‐syndrome profiles of anxiety symptoms. Previous research has shown that Intolerance of Uncertainty (IU) is a core mechanism of anxiety maintenance for clinically anxious populations and for autistic children, adolescents, and adults. The only published study in this area for WS has shown some similar patterns—with an added emphasis on the role of sensory sensitivities—in a sample of older teens and adults (mean age = 24), with the authors highlighting the need for younger samples to consider developmental influences. Here we report a cross‐syndrome, cross‐sectional mediation analyses of children diagnosed with WS or autism, including data from parent surveys of 90 children with WS (n = 48) or autism (n = 42). Group differences showed higher trait levels on all measures for the autism group. Importantly, the relationship between social profile and anxiety was fully mediated by IU level for both groups. This suggests possible similar core mechanisms underlying anxiety in these conditions, and the possibility of generalized intervention approaches especially related to managing distress related to uncertainty in multiple contexts. Lay Summary Autism and Williams Syndrome share some similarities in social profile and also in anxiety traits, but there are also some key differences as well. Comparing them side‐by‐side at the same time improved identification of ways to reduce feelings of anxiety. We found that the intolerance of uncertainty affected the relationship between social profile and anxiety in the same way for young children diagnosed with autism or Williams syndrome, meaning that intervention approaches could be similar for both.

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Training clinicians to deliver group CBT to manage anxiety in youth with ASD: Results of a multisite trial.

Cited by 29 publications

References 44 publications

Diametrically opposed associations between academic achievement and social anxiety among university students with and without autism spectrum disorder

Diametrically opposed associations between academic achievement and social anxiety among university students with and without autism spectrum disorder

Mental health Project ECHO Autism: Increasing access to community mental health services for autistic individuals

“Intolerance of uncertainty” mediates the relationship between social profile and anxiety in both Williams syndrome and autism

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