Introduction
Several types of therapeutic interventions can help improve mental health. These interventions work differently for specific mental problems, but their effectiveness cannot be particular unless thorough research is done to establish their value. Studies show that approximately 50% of children and youths are diagnosed with Autism-Spectrum-Disorder (ASD) (Ramirez et al., 2021). While it is common for people to use Cognitive Behavioral Therapy (CBT) to treat depression, anxiety, and other mental health disorders, it works for various other issues. One of the many benefits of this type of therapy is that it is highly customizable and cost-effective (Fenn & Byrne, 2013). Therefore, different people from different financial backgrounds can use it. However, it is not a common intervention for everyone as it has factored in some disappointments, which leads to the question: is cognitive behavioral therapy intervention effective for treating children and youths diagnosed with ASD and anxiety?
Identifying relevant research
The main objective of this research is to conduct research through peer-reviewed databases and libraries such as EBSCO and Google Scholar to determine research articles that investigate CBT and whether it is effective in treating anxiety in ASD children and youths. The articles found include: “Parent-led, stepped-care cognitive-behavioral therapy for youth with autism and co-occurring anxiety: study rationale and method” (Ramirez et al., 2020), “Modified CBT for social anxiety and social functioning in young adults with autism spectrum disorder” (Bemmer et al., 2021), and “Group Cognitive Behavioral Treatment for Anxiety in Autistic Adolescents with Intellectual Disability: A Pilot and Feasibility Study” (Blakeley‐Smith et al., 2021).
The three articles focus on the Cognitive Behavioral Therapy Intervention in diagnosing anxiety in children and youth with ASD. They comprise qualitative, quantitative, and mixed research designs, including participants, methodology, results, and limitations. They discuss the reasons why CBT is the proper intervention for anxiety. They also look through the limitations of these interventions and ways they can be modified to work efficiently. The integration of these articles in this discussion will contribute additional information on the effectiveness of the study by comparing approaches from different perspectives. Further, the results will be compared to determine the feasibility of CBT in autistic children and youth.
Article 1: “Group Cognitive Behavioral Treatment for Anxiety in Autistic Adolescents with Intellectual Disability: A Pilot and Feasibility Study”
Summary. Anxiety, a common symptom in autistic children and youth, usually interferes with adaptive functioning. In research from Blakeley‐Smith et al. (2021), the CBT programs were assessed for efficacy and feasibility by meeting adolescents’ and children’s communication and behavioral needs. The randomly organized family-focused research was conducted in 14 weeks involving 23 adolescents diagnosed with ASD, anxiety, and intellectual disability. Independent evaluators were involved, but they remained anonymous to the group under study.
The research conducted in this article was quantitative as it employed and analyzed statistical data through primary and secondary outcome measures. The evaluation assessed the anxiety symptoms using severity score scales. The research outcomes indicated that CBT benefits children with ASD and maladaptive anxiety (Blakeley‐Smith et al., 2021). The parent acceptability of the intervention was high, and the anxiety symptoms after intervention showed significant improvement. To ensure consistent evidence for treatment efficacy, the study incorporated experts to assess the integrity of the treatment. The study concluded that the CBT intervention was acceptable and feasible, considering how much the adolescent anxiety improved.
Article 2: “Modified CBT for social anxiety and social functioning in young adults with autism spectrum disorder”
Summary. Young adults with Autism Spectrum are the main targets for elevated social anxiety and poor mental health conditions. It was observed that social anxiety and social functioning would contribute to a change in the overall mood of adolescents and young adults. In the research from Bemmer et al. (2021), an imperative investigation was conducted to identify effective treatment options for adolescents and adults diagnosed with ASD. Adults diagnosed with ASD have a higher chance of mental health problems because transitioning from childhood to adulthood is more difficult. Approximately 70% of co-occurring psychiatric conditions are more likely in adults with ASD (Bemmer et al., 2021). The main objective of the research is to identify the interventions that will contribute to an effective treatment option for ASD functional deficits. It also assessed the target group’s benefit, acceptability, and tolerability of cognitive behavioral therapy.
The research journal used mixed methods to conduct the study, comprising behavioral experiment components and interventions through self-report questionnaires. Participants aged 12-25 were randomly selected from the community and local Headspace centers. Others consisted of referrals from Autism Clinic for Translational Research. The study showed a significant improvement according to the participant’s responses. The findings revealed that the CBT intervention group benefited social awareness and anxiety. It was revealed that the positive feedback from the participants and the nature of the intervention showed that CBT was well tolerated (Bemmer et al., 2021). It also showed a significant improvement in adolescents and young adults diagnosed with ASD. It can also be a clinical utility with more research for further study. The limitation of this research is the lack of a control group to compare the treatment group to, which means that the study cannot directly attribute their gains to the intervention.
Article 3: “Parent-led, stepped-care cognitive-behavioral therapy for youth with autism and co-occurring anxiety: study rationale and method”
Summary: ASD is commonly associated with gastrointestinal illnesses, self-harm-inflicting behaviors, and eventual poor social functional skills with high anxiety levels. In the research article, Ramirez et al. (2020) acknowledge that Behavioral and cognitive therapy is the primary treatment for anxiety disorders. Nonetheless, it has factored in some significant barriers affecting patients seeking treatment. Some of them include high costs of medical charges, lack of insurance coverage, logistics, and inexperienced therapists.
This research factored in two interventions under CBT; Parent-led and step-care interventions. Parent’s-led therapist-assisted has an independent structure of evidence-based treatment at home. This approach has been known to treat cases of anxiety. The step-care concentrates on allocating efficient resources for the child to receive additional care, such as therapy sessions. Step care has been known to treat childhood anxiety and PTSD. These two strategies help improve accessibility by offering personalized care. During the examination, the study participants were requested to complete three sessions in three-month follow-ups; baseline, mid-treatment, and post-treatment. These sessions were administered by trained independent evaluators who practice privately and are advised against discussing treatment programs with the families.
The main objective of this article is to analyze the alternative models to be used that will eliminate the barriers to care. The research method employed in this study involved a qualitative research approach. The study participants involved around 120 youths aged 4-14 diagnosed with ASD and recurrent anxiety. They participated in telephone screening and preliminary screening. The participants that showed more interest in the telephone screening were invited to offer more information. This study provided valuable information on the clinical outcomes of different interventions. The results showed that CBT is expected to generate more advantages, such as cost-effective services and improved accessibility (Ramirez et al., 2020). This article recommends parental involvement to make the intervention more convenient and accessible.
References
Bemmer, E. R., Boulton, K. A., Thomas, E. E., Larke, B., Lah, S., Hickie, I. B., & Guastella, A. J. (2021, February 8). Modified CBT for social anxiety and social functioning in young adults with an autism spectrum disorder. Molecular Autism, 12(1).
Blakeley‐Smith, A., Meyer, A. T., Boles, R. E., & Reaven, J. (2021). Group cognitive Behavioural Treatment for Anxiety in Autistic Adolescents with Intellectual Disability: A Pilot and Feasibility Study. Journal of Applied Research in Intellectual Disabilities, 34(3), 777–788.
Fenn, K., & Byrne, M. (2013). The key principles of cognitive behavioral therapy. InnovAiT: Education and Inspiration for General Practice, 6(9), 579–585.
Ramirez, A. C., Grebe, S. C., McNeel, M. M., Limon, D. L., Schneider, S. C., Berry, L. N., Goin-Kochel, R. P., Cepeda, S. L., Voigt, R. G., Salloum, A., & Storch, E. A. (2020). Parent-led, stepped-care cognitive-behavioral therapy for youth with autism and co-occurring anxiety: study rationale and method. Brazilian Journal of Psychiatry, 42(6), 638–645.
Ramirez, A. C., Perez, M. I., Limon, D., Storch, E. A., & Schneider, S. C. (2021). Cognitive behavioral therapy for anxiety in children with autism spectrum disorders. Diagnosis, Management, and Modeling of Neurodevelopmental Disorders, 447–455.