Group cognitive behaviour therapy (CBT) for social interaction anxiety in adults with autism spectrum disorders (ASD)

Abstract

BackgroundGroup social skills interventions (SSI) are partially effective for addressing the communication and social interaction impairments experienced by individuals with autism spectrum disorders (ASD). Social anxiety has been found to be a moderating mechanism for SSI in young people with ASD. Comparatively few studies have investigated the effectiveness of SSI in the adult ASD population, and none so far have investigated group approaches incorporating SSI and anxiety management techniques. MethodThe present study describes the design and evaluation of a non-randomised single-arm, 11 week group interaction anxiety and social skills intervention, piloted on three occasions during routine clinical practice at an adult ASD service. The intervention was informed by a cognitive behaviour therapy (CBT) framework. Eighteen cognitively-able adult males with ASD attended. Outcome measures were completed pre- and post-intervention. ResultsSelf-reported social anxiety improved (p=0.01, d=0.65). Low mood, general anxiety and functioning did not change significantly (p>0.05, d<0.20). Qualitative feedback indicated that participants found the intervention to be acceptable and useful for improving social knowledge and coping strategies, and reducing avoidance behaviours. Attrition was low (n=2). ConclusionsThese results suggest that integrating SSI and anxiety management techniques in a group format is acceptable to adults with ASD, and can reduce symptoms of social anxiety. Whether SSI enhance social skills in adults requires further investigation. In clinical practice, consideration should be given to augmenting SSI with CBT techniques designed to target concurrent symptoms of social anxiety.