Cognitive behaviour therapy for social anxiety in autism spectrum disorder: a systematic review
Open accessAbstract
Purpose: Individuals who have autism spectrum disorders (ASD) commonly experience anxiety about social interaction and social situations. Cognitive behaviour therapy (CBT) is a recommended treatment for social anxiety (SA) in the non-ASD population. Therapy typically comprises cognitive interventions, imagery-based work and for some individuals, behavioural interventions. Whether these are useful for the ASD population is unclear. Therefore, the purpose of this paper is to undertake a systematic review to summarise research about CBT for SA in ASD. Design/methodology/approach: Using a priori criteria, the authors searched for English-language peer-reviewed empirical studies in five databases. The search yielded 1,364 results. Titles, abstracts, and relevant publications were independently screened by two reviewers. Findings: Four single case studies met the review inclusion criteria; data were synthesised narratively. Participants (three adults and one child) were diagnosed with ASD and SA. There were commonalities in interventions and techniques used: participants were encouraged to identify and challenge negative thoughts, enter anxiety-provoking social situations, and develop new ways of coping. Unlike CBT for SA in non-ASD individuals, treatment also included social skills interventions. Outcomes were assessed using self- or informant-reports. Improvements in SA, depressive symptoms, social skills, and activity levels were noted. Generalisability of results is hampered, however, by the small number of studies and participants and lack of randomised controlled trial conditions employed. Research limitations/implications: Future studies should investigate how beliefs and behaviours indicative of SA can be ameliorated in individuals with ASD. Originality/value: This is the first review to synthesise empirical data about CBT for SA in ASD.
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Autistic people may experience anxiety differently.
“autistic people may experience anxiety differently (Spain et al., 2017).”
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- Authors
- Spain, D., Sin, J., Harwood, L., Mendez, M. A., & Happé, F.
- Affiliations
- King's College London (GB)
- Venue
- Advances in Autism
- Publisher
- Emerald
- Published
- 2017-01-03
- Volume
- 3
- Issue
- 1
- Pages
- 34-46
- ISSN
- 2056-3868 (ISSN-L)
- OpenAlex
- W2562950343
- Cited by
- 37
- References
- 44
- Citations by year
- 2026: 3 · 2025: 3 · 2024: 3 · 2023: 3 · 2022: 5 · 2021: 4 · 2020: 5 · 2019: 3 · 2018: 5 · 2017: 2 · 2012: 1
- FWCI
- 0.46
- Type
- journal article
- Language
- en
- Open access
- green
- doi.org
- Locations
- Advances in Autism (publishedVersion)
- St George's Online Research Archive (St George's University of London) (acceptedVersion)
- CentAUR (University of Reading) (acceptedVersion)
- Research Portal (King's College London) (acceptedVersion, other-oa)
- City Research Online (City University London) (acceptedVersion)
- Funders
- National Institute for Health and Care Research (CDRF-2012-03-059, PDF-2015-08-035)
- King's College London
- Topics
- Life Sciences › Neuroscience › Cognitive Neuroscience › Autism Spectrum Disorder Research
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Social Sciences › Psychology › Clinical Psychology › Psychological Treatments and Assessments
- Keywords
- cognitive behavioral therapy, social anxiety, autism spectrum disorder, social skills training, coping strategies, depressive symptoms, activity level, single case study
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