Abstract
Objectives
One-Session Treatment (OST), a three-hour treatment which includes psychoeducation, exposure, participant modeling, cognitive challenges, and positive reinforcement, has been shown to be effective for the treatment of childhood phobias. Several comorbid anxiety conditions such as Generalized Anxiety Disorder and Social Anxiety Disorder have been shown to have little or no negative effects on treatment outcomes for OST whereas others such as Attention-Deficit Hyperactivity Disorder have been shown to compromise treatment outcomes. This study sought to examine the initial efficacy of OST for children with a behavioral profile demonstrating specific traits of Autism Spectrum Disorder (ASD). We undertook this exploratory study to determine the feasibility and potential efficacy of this brief treatment with these youth.
Methods
Two variations of the treatment were trialed. In the OST condition, the child alone received treatment with minimal parental involvement. In the Augmented OST condition, two clinicians were assigned to each family: one clinician worked with the child and the other with the parent. Families in both treatments returned for follow-up assessments one-week, 6-months, and 1-year later.
Results
A repeated-measures ANOVA revealed significant reductions in phobia severity as well as increases in overall functioning for both forms of treatment.
Conclusions
These results suggest that OST may be an effective intervention for children with ASD traits who evince SPs. Future controlled studies will need to examine the efficacy of this brief intervention with carefully diagnosed youth with ASD as well as explore specific components that make it effective for these children.
![](http://media.springernature.com/m312/springer-static/image/art%3A10.1007%2Fs10826-019-01620-4/MediaObjects/10826_2019_1620_Fig1_HTML.png)
![](http://media.springernature.com/m312/springer-static/image/art%3A10.1007%2Fs10826-019-01620-4/MediaObjects/10826_2019_1620_Fig2_HTML.png)
Similar content being viewed by others
References
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.
Baio, J., Wiggins, L., Christensen, D. L., Maenner, M. J., Daniels, J., Warren, Z., & Durkin, M. S. (2018). Prevalence of autism spectrum disorder among children aged 8 years—autism and developmental disabilities monitoring network, 11 Sites, United States, 2014. MMWR Surveillance Summaries, 67(6), 1–21.
Capriola, N. N., Booker, J. A., & Ollendick, T. H. (2017). Profiles of temperament among youth with specific phobias: implications for CBT outcomes. Journal of Abnormal Child Psychology, 45(7), 1449–1459.
Dadds, M. R., Rapee, R. M., & Barrett, P. M. (1994). Behavioral observation. In T. H. Ollendick, N. K. King, & W. Yule (Eds). International handbook of phobic and anxiety disorders in children and adolescents (pp. 349–364). Boston, MA: Springer.
Davis, III, T. E., Kurtz, P. F., Gardner, A. W., & Carman, N. B. (2007). Cognitive-behavioral treatment for specific phobias with a child demonstrating severe problem behavior and developmental delays. Research in Developmental Disabilities, 28(6), 546–558.
Davis, III, T. E., May, A., & Whiting, S. E. (2011). Evidence-based treatment of anxiety and phobia in children and adolescents: current status and effects on the emotional response. Clinical Psychology Review, 31(4), 592–602.
Davis, III, T. E., Ollendick, T. H., & Öst, L.-G. (2019). One-session treatment of phobias in children: recent developments and a systematic review. Annual Review of Clinical Psychology, 15, 233–256.
Farrell, L. J., Kershaw, H., & Ollendick, T. (2018). Play-modified one-session treatment for young children with a specific phobia of dogs: a multiple baseline case series. Child Psychiatry & Human Development, 49(2), 317–329.
Granpeesheh, D., Dixon, D. R., Tarbox, J., Kaplan, A. M., & Wilke, A. E. (2009). The effects of age and treatment intensity on behavioral intervention outcomes for children with autism spectrum disorders. Research in Autism Spectrum Disorders, 3(4), 1014–1022.
Hagopian, L. P., Lilly, M., & Davis, T. E. (2017). Behavioral treatments for anxiety in minimally verbal children with ASD. In Anxiety in Children and Adolescents with Autism Spectrum Disorder (pp. 193–210). Academic Press.
Halldorsdottir, T., & Ollendick, T. H. (2016). Long-term outcomes of brief, intensive CBT for specific phobias: The negative impact of ADHD symptoms. Journal of Consulting and Clinical Psychology, 84(5), 465.
Hersen, M., & Bellack, A. S. (Eds). (1976). Behavioral assessment: A practical handbook (Vol. 65). Pergamon Press.
IBM Corp. Released 2017. IBM SPSS statistics for windows, Version25.0. Armonk, NY: IBM Corp.
Kendall, P. C., & Beidas, R. S. (2007). Smoothing the trail for dissemination of evidence-based practices for youth: flexibility within fidelity. Professional Psychology: Research and Practice, 38(1), 13.
Kershaw, H., Farrell, L. J., Donovan, C., & Ollendick, T. (2017). Cognitive behavioral therapy in a one-session treatment for a preschooler with specific phobias. Journal of Cognitive Psychotherapy, 31(1), 7–22.
Lieb, R., Miché, M., Gloster, A. T., Beesdo-Baum, K., Meyer, A. H., & Wittchen, H. U. (2016). Impact of specific phobia on the risk of onset of mental disorders: a 10-year prospective-longitudinal community study of adolescents and young adults. Depression and Anxiety, 33(7), 667–675.
Lord, C., Rutter, M., DiLavore, P. C., & Risi, S. (2003). Autism diagnostic observation schedule: ADOS. Los Angeles, CA: Western Psychological Services.
Mayes, S. D., Calhoun, S. L., Aggarwal, R., Baker, C., Mathapati, S., Molitoris, S., & Mayes, R. D. (2013). Unusual fears in children with autism. Research in Autism Spectrum Disorders, 7(1), 151–158.
Moree, B. N., & Davis, III, T. E. (2010). Cognitive-behavioral therapy for anxiety in children diagnosed with autism spectrum disorders: Modification trends. Research in Autism Spectrum Disorders, 4(3), 346–354.
Ollendick, T. H., Halldorsdottir, T., Fraire, M. G., Austin, K. E., Noguchi, R. J., Lewis, K. M., & Whitmore, M. J. (2015). Specific phobias in youth: a randomized controlled trial comparing one-session treatment to a parent-augmented one-session treatment. Behavior Therapy, 46(2), 141–155.
Ollendick, T. H., Lewis, K. M., Cowart, M. J., & Davis, III, T. (2012). Prediction of child performance on a parent–child behavioral approach test with animal phobic children. Behavior Modification, 36(4), 509–524.
Ollendick, T. H., Öst, L. G., Reuterskiöld, L., Costa, N., Cederlund, R., Sirbu, C., & Jarrett, M. A. (2009). One-session treatment of specific phobias in youth: a randomized clinical trial in the United States and Sweden. Journal of Consulting and Clinical Psychology, 77(3), 504.
Öst, L. G. (1989). One-session treatment for specific phobias. Behaviour Research and Therapy, 27(1), 1–7.
Öst, L. G., & Ollendick, T. H. (2017). Brief, intensive and concentrated cognitive behavioral treatments for anxiety disorders in children: a systematic review and meta-analysis. Behaviour Research and Therapy, 97, 134–145.
Öst, L. G., Svensson, L., Hellström, K., & Lindwall, R. (2001). One-session treatment of specific phobias in youths: a randomized clinical trial. Journal of Consulting and Clinical Psychology, 69(5), 814–824.
Ryan, S. M., Strege, M. V., Oar, E. L., & Ollendick, T. H. (2017). One session treatment for specific phobias in children: comorbid anxiety disorders and treatment outcome. Journal of Behavior Therapy and Experimental Psychiatry, 54, 128–134.
Ruzich, E., Allison, C., Smith, P., Watson, P., Auyeung, B., Ring, H., & Baron‐Cohen, S. (2016). Subgrouping siblings of people with autism: Identifying the broader autism phenotype. Autism Research, 9(6), 658–665.
Rutter, M., Le Couteur, A., & Lord, C. (2003). Autism diagnostic interview-revised. Los Angeles, CA: Western Psychological Services. 29, 30.
Rudy, B. M., & Davis III, T. E. (2012). Interventions for specific phobia in special populations. In Intensive one-session treatment of specific phobias (pp. 177–193). New York, NY: Springer.
Shaffer, D., Gould, M. S., Brasic, J., Ambrosini, P., Fisher, P., Bird, H., & Aluwahlia, S. (1983). A children’s global assessment scale (CGAS). Archives of General psychiatry, 40(11), 1228–1231.
Silverman, W. K., Albano, A. M., & Barlow, D. H. (1996). Manual for the ADIS-IV-C/P. New York, NY: Psychological Corporation.
Sze, K. M., & Wood, J. J. (2008). Enhancing CBT for the treatment of autism spectrum disorders and concurrent anxiety. Behavioural and Cognitive Psychotherapy, 36(4), 403–409.
Vasa, R. A., & Mazurek, M. O. (2015). An update on anxiety in youth with autism spectrum disorders. Current Opinion in Psychiatry, 28(2), 83.
White, S. W., Oswald, D., Ollendick, T., & Scahill, L. (2009). Anxiety in children and adolescents with autism spectrum disorders. Clinical Psychology Review, 29(3), 216–229.
Wood, J. J., Drahota, A., Sze, K., Har, K., Chiu, A., & Langer, D. A. (2009). Cognitive behavioral therapy for anxiety in children with autism spectrum disorders: a randomized, controlled trial. Journal of Child Psychology and Psychiatry, 50(3), 224–234.
Funding
National Institute of Mental Health (R01 MH59308; PI Thomas Ollendick); National Institute of Mental Health (R01 MH074777; PI Thomas Ollendick).
Author Contributions
AM: Proposed analyses for the data, collaborated on conducting analyses and writing of the paper. SRR: Collaborated on conducting analyses and writing the paper. TO: Collaborated on designing and conducting initial clinical trials from which the data came, and collaborated on the writing of the paper.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of Interest
All authors declare that they have no conflict of interest.
Ethical Approval
The data presented in this study were approved by the Virginia Polytechnic Institute and State University Institutional Review Board.
Informed Consent
Informed consent/assent was obtained from all participants in the study. All participants provided both verbal and written consent/assent after having the contents of both these forms summarized out loud and being given the opportunity to ask questions.
Additional information
Publisher’s note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
About this article
Cite this article
Muskett, A., Radtke, S.R. & Ollendick, T. A Pilot Study of One-Session Treatment for Specific Phobias in Children with ASD Traits. J Child Fam Stud 29, 1021–1028 (2020). https://doi.org/10.1007/s10826-019-01620-4
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10826-019-01620-4