“Less stress”: a pilot study on a cognitive behavioral treatment program for anxiety in children with autism spectrum disorders
, , and | Mar 25, 2021
About this article
Article Category: research-article
Published Online: Mar 25, 2021
Page range: 30 - 40
DOI: https://doi.org/10.21307/sjcapp-2021-005
Keywords
© 2021 Beate Oerbeck et al., published by sciendo.
This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Comparing baseline values for completers and non-completers
| Age years | IQ | CGAS | SRS | RCADS | Number of anxiety diagnoses | Comorbid ADHD | |
|---|---|---|---|---|---|---|---|
| Non-completers (n = 2) | 9.5 | 99 | 51 | t = 71 | t = 83 | n = 1 in both | 1 of 2 |
| Completers (n = 8) | 9.5 | 88 | 40 | t = 96 | t = 97 | Range 1-5, mean 2 | 6 of 8 |
Therapist rated adherence and competence
| Items rated by the therapist after every session | Mean (SD) range |
|---|---|
| 1. To what extent did you follow the specified structure for the session? | 3.5 (0.5) 2-4 |
| 2. To what extent did you demonstrate your therapeutic process and relationship skills? | 3.5 (0.4) 2-4 |
| 3. To what extent did you think you focused on the goals set for the session? | 3.5 (0.3) 2-4 |
| 4. Based on an overall assessment, how competently did you experience yourself as a therapist this session? | 3.4 (0-5) 2-4 |
User satisfaction rated by parents and children
| Mother | Father | Child | |
|---|---|---|---|
| Items | Mean (SD) | Mean (SD) | Mean (SD) |
| I found the” Less Stress” program useful | 7.0 (0.0) | 6.6 (0.5) | 6.1 (0.8) |
| I have used some of what I learned during the program | 6.9 (0.4) | 5.4 (0.9) | 5.8 (0.9) |
| I liked the “Less Stress” program | 6.8 (0.5) | 6.4 (0.5) | 5.8 (2.1) |
| I will continue to use what I learned in the program | 6.8 (0.5) | 6.0 (0.7) | 5.9 (0.8) |
| I remember what I learned in the program | 6.4 (0.7) | 5.3 (0.5) | 5.5 (0.8) |
| Did you talk to your child/parent about “Less Stress”? (yes = 1 / no = 0) | 1.0 (0.0) | 0.6 (0.5) | 0.9 (0.4) |
| Were you content with the therapist? | 8.8 (0.5) | 8.4 (0.5) | 7.9 (1.8) |
Questionnaire ratings at baseline and after treatment
| Questionnaires, raters | Baseline ratings N=10 | After treatment N=8 | Statistics | |
|---|---|---|---|---|
| Mean (SD) range | Mean (SD) range | t-value |
|
|
| CGAS, clinician-rated | 42.4 (6.9) 32-52 | 48.3 (3.8) 41-55 | -3.85 | < .01 |
| SRS t-score, mother | 91.1 (12.6) 62-109 | 85.9 (11.0) 64-103 | 3.03 | .02 |
| RCADS t-score, mother | 94.6 (11.0) 74-118 | 73.2 (20.1) 50-110 | 4.25 | < .01 |
| RCADS t-score, father | 96.2 (16.3) 76-115 | 75.6 (17.9) 53-112 | 2.73 | .04 |
| RCADS t-score, child | 67.0 (16.0) 38-82 | 60.0 (12.7) 43-76 | 4.06 | .01 |
| ILC total score, child | 16.6 (4.4) 9-21 | 18.9 (3.6) 13-24 | -2.24 | .07 |
| ILC PR score, child | 3.6 (1.5) 2-6 | 3.0 (1.7) 0-5 | 1.66 | .16 |
| CALIS raw score, mother | 50.1 (6.0) 39-59 | 41.8 (10.3) 20-53 | 2.16 | .07 |
| CALIS raw score, father | 45.4 (6.7) 37-55 | 37.6 (12.8) 20-59 | 1.65 | .16 |
Overview of the “Less Stress” sessions
| Session | Content |
|---|---|
| Parent session 1 | Conducted before session 1. Parents receive information regarding the program and the role of the parent during the treatment |
| Session 1 | “Getting to know each other” exercise. Introduction to the program, assessment of the child’s interests and what makes the child happy. Assessment of potential rewards that could be used |
| Session 2 | Psychoeducation on feelings, relaxation and anxiety. Setting goals for the program |
| Session 3 | Creating a toolbox for emotion regulation (”Relaxation tools” and “Special interest tools” based on sessions 1 and 2, and introduction to “Physical tools”, “Social tools”, “Other tools” and “Unhelpful tools”) |
| Session 4 | “Thinking tools” (cognitive restructuring) and “Doing-tools” (exposure) |
| Session 5 | “Thinking tools” and “Doing-tools” |
| Session 6 | “Problemsolving tools” + Exposure |
| Session 7 | “Completing the toolbox” + Exposure |
| Parent session 2 | Conducted before session 8: Update on progress/goal setting. Information regarding exposure work and role of the parents in the next treatment phase |
| Session 8-13 | Exposure-based targeting of the main anxiety problem(s) |
| Follow-up sessions 1-3 | Three follow-up sessions with a monthly interval (starting 1 month after session 13) |