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Journal of Contemporary Psychotherapy

, Volume 48, Issue 3, pp 155–163 | Cite as

Cognitive-Behavioral Therapy in the Treatment of Internalizing Disorders in High-Functioning Youth with Autism Spectrum Disorder

  • Kimberly Burkhart
  • Michele Knox
  • Kimberly Hunter
Original Paper
  • 358 Downloads

Abstract

Anxiety and depression are often comorbid with Autism Spectrum Disorder (ASD). There is empirical support to suggest that cognitive-behavioral therapy (CBT) is an efficacious treatment for comorbid anxiety disorders in youth with ASD. Modifications to CBT for youths with ASD have been made with emphasis on exposure being a critical component. Few studies have evaluated the efficacy of CBT on symptoms of depression in youths with ASD. Modifications to CBT will be outlined in this review, as will implementation suggestions for the clinician practicing CBT with ASD youth. Limitations of the studies investigating this intervention include small sample sizes, clinician- and parent-report of symptom change but not consistent self-identified change, limited validated tools for assessing change, and lack of long-term follow-up.

Keywords

Autism spectrum disorder Cognitive-behavioral therapy Internalizing disorders 

Notes

Conflict of interest

All authors declare no conflict of interest.

References

  1. Achenbach, L. A., & Rescorla, T. M. (2001). Manual for ASEBA school-age forms & profiles. Burlington, VT: University of Vermont, Research Center for Children, Youth, & Families.Google Scholar
  2. Attwood, T. (2004). Exploring feelings (anxiety). Arlington, TX: Future Horizons.Google Scholar
  3. Attwood, T., & Garnett, M. (2013). Exploring depression: Cognitive behaviour therapy to understand and cope with depression. London: Jessica Kingsley Publishers.Google Scholar
  4. Barrett, P. M., Sonderegger, R., & Xenos, S. (2003). Using FRIENDS to combat anxiety and adjustment problems among young migrants to Australia. A national trial. Clinical Child Psychology & Psychiatry, 8, 241–260.CrossRefGoogle Scholar
  5. Beck, A. T., Steer, R. A., & Brown, G. K. (1996). Beck depression inventory manual (2nd edn.). San Antonia, TX: Psychological Corporation.Google Scholar
  6. Birmaker, B., Brent, D. A., Chiapetta, L., Bridge, J., Monga, S., & Baugher, M. (1999). Psychometric properties of the screen for child anxiety related emotional disorders (SCARED): A replication study. Journal of the American Academy of Child and Adolescent Psychiatry, 38(10), 1230–1236.CrossRefGoogle Scholar
  7. Cash, S. J., & Bridge, J. A. (2009). Epidemiology of youth suicide and suicidal behavior. Current Opinion in Pediatrics, 21(5), 613–619.CrossRefPubMedPubMedCentralGoogle Scholar
  8. Chalfant, A. M., Rapee, R., & Carroll, L. (2007). Treating anxiety disorders in children with high functioning autism spectrum disorders: A controlled trial. Journal of Autism and Developmental Disorders, 37(10), 1842–1857.CrossRefPubMedGoogle Scholar
  9. Chorpita, B. F., & Daleidan, E. L. (2009). Mapping evidence-based treatments for children and adolescents: Application of the distillation and matching model to 615 treatments. Journal of Counseling and Clinical Psychology, 77(3), 566–579.CrossRefGoogle Scholar
  10. Constantino, J. N. (2002). The social responsiveness scale. Los Angeles: Western Psychological Services.Google Scholar
  11. Danial, J. T., & Wood, J. J. (2013). Cognitive behavioral therapy for children with autism: Review and considerations for future research. Journal of Developmental and Behavioral Pediatrics, 34(9), 702–715.CrossRefPubMedGoogle Scholar
  12. Davis, T. E., & Ollendick, T. H. (2005). Empirically supported treatments for specific phobia in children: Do efficacious treatments address the components of a phobic response? Clinical Psychological Science Practice, 12(2), 144–160.CrossRefGoogle Scholar
  13. Davis, T. E., White, S. W., & Ollendick, T. H. (2014). Handbook of autism and anxiety. New York: Springer.CrossRefGoogle Scholar
  14. Drahota, A., Wood, J. J., Sze, K. M., & Van Dyke, M. (2011). Effects of cognitive behavioral therapy on daily living skills in children with high-functioning autism and concurrent anxiety disorders. Journal of Autism and Developmental Disorders, 41(3), 257–265.CrossRefPubMedGoogle Scholar
  15. Flannery-Schroeder, E., Choudbury, M. S., & Kendall, P. C. (2005). Group and individual cognitive-behavioral treatments for youth with anxiety disorders: 1-year follow-up. Cognitive Therapy and Research, 29(2), 253–259.CrossRefGoogle Scholar
  16. Fujii, C., Renno, P., McLeod, B. D., Lin, C. E., Decker, K., Zielinski, K., & Wood, J. J. (2013). Intensive cognitive behavioral therapy for anxiety disorders in school-aged children with autism: A preliminary comparison with treatment-as-usual. School Mental Health, 5, 25–37.CrossRefGoogle Scholar
  17. Ghaziuddin, M., Ghaziuddin, N., & Greden, J. (2002). Depression in persons with autism: Implications for research and clinical care. Journal of Autism and Developmental Disorders, 32, 299–306.CrossRefPubMedGoogle Scholar
  18. Green, J., Gilchrist, A., Burton, D., & Cox, A. (2000). Social and psychiatric functioning in adolescents with asperger syndrome compared with conduct disorder. Journal of Autism and Developmental Disorders, 30(4), 279–293.CrossRefPubMedGoogle Scholar
  19. Gross, J. J., & John, O. P. (2003). Individual differences in two emotion regulation processes: Implications for affect, relationships, and well-being. Journal of Personality and Social Psychology, 85(2), 348–363.CrossRefPubMedGoogle Scholar
  20. Gross, J. J., & Thomspon, R. A. (2007). Emotion regulation: Conceptual foundations. In J. J. Gross (Ed.), Handbook of emotion regulation. New York: Guilford Press.Google Scholar
  21. Guy, W. (1976). Early clinical evaluation unit (ECDEU) assessment manual for Psychopharmacology. Revised NIMH publication DHEW publNO (Adm) 76-338 (pp. 217–222). Bethesda, MD: National Institute of Mental Health.Google Scholar
  22. Hannon, G., & Taylor, E. P. (2013). Suicidal behavior in adolescents and young adults with ASD: Findings from a systematic review. Clinical Psychology Review, 33(8), 1197–1204.CrossRefPubMedGoogle Scholar
  23. Hofmann, S. G., Asnaani, A., Vonk, I. J., Sawyer, A. T., & Fang, A. (2012). The efficacy of cognitive behavioral therapy: A review of meta-analyses. Cognitive Therapy and Research, 36(5), 427–440.CrossRefPubMedPubMedCentralGoogle Scholar
  24. Keehn, R. H. M., Lincoln, A. J., Brown, M. Z., & Chavira, D. A. (2013). The Coping Cat program for children with anxiety and autism spectrum disorder: A pilot randomized controlled trial. Journal of Autism and Developmental Disorders, 43(1), 57–67.CrossRefGoogle Scholar
  25. Kendall, P. C., & Hedtke, K. A. (2006). Cognitive-behavioral therapy for anxious youth: Therapist manual (3rd edn.). Ardmore, PA: Workbook Publishing.Google Scholar
  26. Kerns, C. M., Renno, P., Storch, E. A., Kendall, P. C., & Wood, J. J. (Eds.). (2017). Anxiety in children and adolescents with autism spectrum disorder. San Diego, CA: Academic Press.Google Scholar
  27. Kerns, C. M., Wood, J. J., Kendall, P. C., Renno, P., Crawford, E. A., & Mercado, R. J., et al. (2016). The treatment of anxiety in autism spectrum disorders (TAASD) study: Rationale, design, and methods. Journal of Child and Family Studies, 25, 1889–1902.CrossRefPubMedPubMedCentralGoogle Scholar
  28. Kim, J. A., Szatmari, P., Bryson, S. E., Streiner, D. L., & Wilson, F. J. (2000). The prevalence of anxiety and mood problems among children with autism and asperger syndrome. Autism, 4, 117–132.CrossRefGoogle Scholar
  29. Lovibond, S., & Lovibond, P. (1995). The structure of negative emotional states: Comparison of the depression anxiety stress scale (DASS) with the beck depression and anxiety inventories. Behaviour Research and Therapy, 33, 335–343.CrossRefPubMedGoogle Scholar
  30. McConachie, H., McLaughlin, E., Grahame, V., Taylor, H., Honey, E., Tavernor, L., et al. (2014). Group therapy for anxiety in children with autism spectrum disorder. Autism, 18(6), 723–732.CrossRefPubMedGoogle Scholar
  31. McGillivray, J. A., & Evert, H. T. (2014). Group cognitive behavioral therapy program shows potential in reducing symptoms of depression and stress among young people with ASD. Journal of Autism and Developmental Disorders, 44, 2041–2051.CrossRefPubMedGoogle Scholar
  32. Moree, B. N., & Davis, T. E. (2010). Cognitive-behavioral therapy for anxiety in children diagnosed with autism spectrum disorders: Modification trends. Research on Autism Spectrum Disorder, 4(3), 346–354.CrossRefGoogle Scholar
  33. Read, K. L., Pueleo, C. M., Wei, C., Cummings, C. M., & Kendall, P. C. (2013). Cognitive-behavioral treatment for pediatric anxiety disorders. In Pediatric anxiety disorders (pp. 269–287). New York: Springer.CrossRefGoogle Scholar
  34. Reaven, J., Blakeley-Smith, A., Culhane-Shelburne, K., & Hepburn, E., S (2012a). Group cognitive behavior therapy for children with high-functioning autism spectrum disorders and anxiety: A randomized trial. Journal of Child Psychology and Psychiatry, 53(4), 410–419.CrossRefPubMedGoogle Scholar
  35. Reaven, J., Blakeley-Smith, A., Leuthe, E., Moody, E., & Helpburn, S. (2012b). Facing your fears in adolescence: Cognitive-behavioral therapy for high-functioning autism spectrum disorders and anxiety. In Autism research and treatment. Available at  https://doi.org/10.1155/2012/423905.
  36. Reaven, J., Blakely-Smith, A., Nichols, S., & Hepburn, S. (2011). Facing your fears: Group therapy for managing anxiety in children with high-functioning autism spectrum disorders. Baltimore: Paul Brookes Publishing.Google Scholar
  37. Resch, F., Parzer, P., & Romuald, B. (2008). Self-mutilation and suicidal behavior in children and adolescents: Prevalence and psychosocial correlates: Results of the BELLA study. European Child and Adolescent Psychiatry, 17(1), 92–98.CrossRefPubMedGoogle Scholar
  38. Santomauro, D., Sheffield, J., & Sofronoff, K. (2016). Depression in adolescents with ASD: A pilot RCT of a group intervention. Journal of Autism and Developmental Disorders, 46(2), 572–588.Google Scholar
  39. Scattone, D., & Mong, M. (2013). Cognitive behavior therapy in the treatment of anxiety for adolescents and adults with autism spectrum disorders. Psychology in Schools, 50(9), 923–935.CrossRefGoogle Scholar
  40. Silverman, W. K., & Albano, A. M. (1996). The anxiety disorders interview schedule for DSM-IV-child and parent versions. San Antonio, TX: Granwind.Google Scholar
  41. Simonoff, E., Pickles, A., Charman, T., Chandler, S., Loucas, T., & Baird, G. (2008). Psychiatric disorders in children with autism spectrum disorders: Prevalence, comorbidity, and associated factors in a population-derived sample. Journal of the American Academy of Child & Adolescent Psychiatry, 47, 921–929.CrossRefGoogle Scholar
  42. Sofronoff, K., Attwood, T., & Hinton, S. (2005). A randomized controlled trial of a CBT intervention for anxiety in children with asperger syndrome. Journal of Child Psychology and Psychiatry, 46, 1152–1160.CrossRefPubMedGoogle Scholar
  43. Storch, E. A., Arnold, E. B., Lewin, A. B., Nadeau, J. M., Jones, A. M., De Nadai, A. S., et al. (2013). The effect of cognitive-behavioral therapy versus treatment as usual for anxiety in children with autism spectrum disorders: A randomized, controlled trial. Journal of the American Academy of Child and Adolescent Psychiatry, 52(2), 132–142.CrossRefPubMedGoogle Scholar
  44. Storch, E. A., Lewin, A. B., Collier, A. B., Arnold, E., De Nadai, A. S., Dane, B. F., et al. (2015). A randomized controlled trial of cognitive behavioral therapy versus treatment as usual for adolescents with autism spectrum disorders and comorbid anxiety. Depression and Anxiety, 32(3), 174–181.CrossRefPubMedGoogle Scholar
  45. Strang, J. F., Kenworthy, L., Daniolos, P., Case, L., Wills, M. C., Martin, A., & Wallace, G. L. (2012). Depression and anxiety symptoms in children and adolescents with autism spectrum disorders without intellectual disability. Research in Autism Spectrum Disorders, 6, 406–412.CrossRefPubMedPubMedCentralGoogle Scholar
  46. Sung, M., Ooi, Y. P., Goh, T. J., Pathy, P., Fung, D. S. S., Ang, R. P., et al. (2011). Effects of cognitive-behavioral therapy on anxiety in children with autism spectrum disorders: A randomized controlled trial. Child Psychiatry and Human Development, 42(6), 634–649.CrossRefPubMedGoogle Scholar
  47. Ung, D., Selles, R., Small, B. J., & Storch, E. A. (2015). A systematic review and meta-analysis of cognitive-behavioral therapy for anxiety in youth with high-functioning autism spectrum disorders. Child Psychiatry and Human Development, 46, 533–547.CrossRefPubMedGoogle Scholar
  48. White, S. W., Albano, A. M., Johnson, C. R., Kasari, C., Ollendick, T., Klin, A., et al. (2010). Development of a cognitive-behavioral intervention program to treat anxiety and social deficits in teens with high-functioning autism. Clinical Child and Family Psychological Review, 13(1), 77–90.CrossRefGoogle Scholar
  49. White, S. W., Ollendick, T., Albano, A. M., Oswald, D., Johnson, C., Southam-Gerow, M. A., et al. (2013). Randomized controlled trial: Multimodal anxiety and social skill intervention for adolescents with autism spectrum disorder. Journal of Autism and Developmental Disorders, 43(2), 382–394.CrossRefPubMedPubMedCentralGoogle Scholar
  50. White, S. W., Oswald, D., Ollendick, T., & Scahill, L. (2009). Anxiety in children and adolescents with autism spectrum disorders. Clinical Psychology Review, 29, 216–229.CrossRefPubMedPubMedCentralGoogle Scholar
  51. 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.CrossRefPubMedGoogle Scholar
  52. Wood, J. J., Ehrenreich-May, J., Alessandri, M., Fujii, C., Renno, P., Laugeson, E., et al. (2015). Cognitive behavioral therapy for early adolescents with autism spectrum disorders and clinical anxiety: A randomized, controlled trial. Behavioral Therapy, 46(1), 7–19.CrossRefGoogle Scholar
  53. Wood, J. J., Fujii, C., Renno, P., & Van Dyke, M. (2014). Impact of cognitive behavioral therapy on observed autism symptom severity during school recess: A preliminary randomized, controlled trial. Journal of Autism and Developmental Disorders, 44, 2264–2276.PubMedGoogle Scholar
  54. Wood, J. J., & McLeod, B. (2008). Child anxiety disorders: A treatment manual for practitioners. New York: Norton.Google Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2017

Authors and Affiliations

  1. 1.Rainbow Babies and Children’s HospitalCase Western Reserve UniversityClevelandUSA
  2. 2.University of Toledo College of Medicine and Life SciencesToledoUSA

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