The aim of today’s article is to present a preliminary study on the feasibility and effectiveness of a Single-Session Treatment (SST) for Anxiety Disorders adapted for children with Autism Spectrum Disorder (ASD) (Ollendick et al., 2020).
It has been widely demonstrated that Single-Session Interventions help prevent mental health problems and reduce barriers to accessing psychological counseling services. The study presented in this article provides an additional application of the SST method in the field of anxiety disorders. Anxiety disorders are common among individuals with ASD, for whom several therapeutic adaptations have been proposed (Moree & Davis, 2010).
Autism Spectrum Disorder: What It Is and How It Manifests
According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) (APA, 2013), Autism Spectrum Disorder is a neurodevelopmental condition that emerges in early childhood and is characterized by:
- Persistent deficits in social communication and social interaction across multiple contexts (e.g., family, school);
- Restricted and/or repetitive patterns of behavior, interests, or activities, as well as alterations in sensory perception.
These dimensions are not the only features that characterize ASD. For an accurate diagnosis, additional specific descriptors must be considered, including the presence or absence of intellectual impairment, language impairment, medical, genetic, or environmental conditions, and other neurodevelopmental, mental, or behavioral disorders.
Another fundamental assessment criterion is the severity level and the amount of support required, defined across three levels of impairment in the two main dimensions described above:
- Level 1 – Requiring support.
- Level 2 – Requiring substantial support.
- Level 3 – Requiring very substantial support.
Autism Spectrum Disorder (ASD) and Anxiety Disorders (AD)
Although there is broad agreement that anxiety disorders are among the most common comorbid conditions associated with ASD, a recent study reported prevalence rates of approximately 50% (Kent & Simonoff, 2017). In many cases, anxiety disorders in young people with autism present symptoms similar to those observed in typically developing youth.
However, in young people with ASD, identifying anxiety symptoms can be challenging due to their overlap with other symptoms commonly associated with Autism Spectrum Disorder (White et al., 2009a, b).
Furthermore, many families may not seek treatment for anxiety disorders in children with ASD, considering them less severe than other symptoms specific to the condition (Mason & Scior, 2004). Based on these considerations, several studies have suggested adapting treatments for children with ASD.
What Is Addressed in the Study Presented in This Article?
The study describes how a standard Single-Session Treatment for anxiety problems (Öst et al., 2001) can be adapted for individuals with ASD while still achieving effective outcomes.
Let’s See How!
The standard treatment consists of a 3-hour session based on psychoeducation, exposure, modeling, cognitive challenges, and positive reinforcement, followed by four weekly telephone calls to monitor progress regarding the issue addressed during the session.
In the Single-Session Treatment specifically adapted for anxiety in children with ASD, additional modifications include greater parental involvement, the use of visual supports, and the inclusion of four 1-hour booster sessions instead of the four weekly phone calls.
What Were the Findings?
Clinical observations and Friedman tests (a non-parametric data analysis method) applied to the treatment groups revealed significant reductions in fear ratings and phobia severity from pre-treatment to post-treatment and follow-up assessments. In addition, changes in behavioral avoidance were observed. These findings provide evidence that this treatment approach warrants further investigation (Muskett et al., 2020).
Conclusions
The study suggests that a Single-Session Therapy approach for anxiety disorders adapted for children with Autism Spectrum Disorder may be an effective intervention. Future controlled studies will be useful in examining its effectiveness among carefully diagnosed young people, as well as exploring the specific components that contribute to its success in children with autism-related challenges.
Angelica Giannetti
Psychologist, Psychotherapist
Italian Center for Single Session Therapy Team
References
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White, S. W., Ollendick, T., Scahill, L., Oswald, D., & Albano, A. M. (2009a). Preliminary efficacy of a cognitive-behavioral treatment program for anxious youth with autism spectrum disorders. Journal of Autism and Developmental Disorders, 39(12), 1652.
White, S. W., Oswald, D., Ollendick, T., & Scahill, L. (2009b). Anxiety in children and adolescents with autism spectrum disorders. Clinical Psychology Review, 29(3), 216–229.