Outcomes of cognitive behaviour therapy for obsessive–compulsive disorder in young people with and without autism spectrum disorders: A case controlled study

2015 ◽  
Vol 228 (1) ◽  
pp. 8-13 ◽  
Author(s):  
Kim Murray ◽  
Amita Jassi ◽  
David Mataix-Cols ◽  
Faye Barrow ◽  
Georgina Krebs
Author(s):  
Amita Jassi ◽  
Lorena Fernández de la Cruz ◽  
Ailsa Russell ◽  
Georgina Krebs

Abstract Obsessive–compulsive disorder (OCD) and autism spectrum disorder (ASD) frequently co-occur. Standard cognitive behaviour therapy (CBT) for OCD outcomes are poorer in young people with ASD, compared to those without. The aim of this naturalistic study was to evaluate the effectiveness of a novel adolescent autism-adapted CBT manual for OCD in a specialist clinical setting. Additionally, we examined whether treatment gains were maintained at 3-month follow-up. Thirty-four adolescents underwent CBT; at the end of treatment, 51.51% were treatment responders and 21.21% were in remission. At 3-month follow-up, 52.94% were responders and 35.29% remitters. Significant improvements were also observed on a range of secondary measures, including family accommodation and global functioning. This study indicates this adapted package of CBT is associated with significant improvements in OCD outcomes, with superior outcomes to those reported in previous studies. Further investigation of the generalizability of these results, as well as dissemination to different settings, is warranted.


2019 ◽  
Vol 38 (2) ◽  
pp. 184-208 ◽  
Author(s):  
Debbie Spain ◽  
Francesca Happé

AbstractChildren and adults with autism spectrum disorders (ASD) can benefit from cognitive behaviour therapy (CBT), yet the prevailing opinion is that this requires adaptations to accommodate commonly experienced socio-communication and neuropsychological impairments. There are, however, no empirically-derived guidelines about how best to adapt standard practice. In a three round Delphi survey, we asked expert clinicians and clinical-researchers, based in England, about how to optimise the design, delivery and evaluation of CBT for people with ASD. Of 50 people approached, 18 consented to take part in Round 1, nine in Round 2 and eight in Round 3. Using a five-point scale, participants rated the degree to which 221 statements—pertaining to the referral process, assessment, engagement, formulation, goal setting, therapy structure, interventions and techniques, homework, outcome measurement, managing endings and therapist attributes—were integral to CBT. The consensus was that 155 statements represented essential or important components of CBT. Adaptations to the structure and process of therapy were consistently endorsed, and an individualised formulation-derived approach was favoured when deciding upon which interventions and techniques to offer. Further studies are needed to clarify if adapted CBT is associated with improved treatment outcomes and acceptability.


2017 ◽  
Vol 3 (2) ◽  
pp. 66-75 ◽  
Author(s):  
Debbie Spain ◽  
Sarah H. Blainey

Purpose Psychosocial risk factors and high rates of psychiatric comorbidity render individuals with autism spectrum disorders (ASD) vulnerable to developing low self-esteem (LSE). Cognitive behaviour therapy (CBT) interventions are effective for enhancing self-esteem in typically developing populations, but the degree to which they are clinically beneficial for individuals with ASD has been little explored. The paper aims to discuss these issues. Design/methodology/approach A pilot group intervention was undertaken to investigate the effectiveness and acceptability of CBT for LSE in adults with ASD. Adaptations to standard protocols were made, in order to accommodate core ASD characteristics. Findings Four participants attended eight sessions: these comprised formulation of causal and maintaining mechanisms for LSE, cognitive interventions designed to reduce self-criticism and promote a more balanced self-view, and behavioural interventions intended to increase engagement in enjoyable activities, and enhance problem-solving skills and assertiveness. Self-report questionnaires were completed at four time points: baseline, at the first and last sessions, and at one-month follow-up. Data analysis indicated no change in the primary self-esteem outcome measure. Some improvements were noted on secondary outcomes, specifically in social anxiety and depressive symptoms, and general functioning. Research limitations/implications Further studies are needed to determine how to design and deliver CBT interventions and techniques which target LSE in individuals with ASD. Originality/value This is one of the first CBT group interventions designed to address LSE in adults with ASD.


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