Cognitive behavioral therapy in high-functioning autism: Review and recommendations for treatment development

Abstract

Individuals with autism spectrum disorders (ASDs) who have acquired functional communication strategies - particularly more cognitively able individuals at or beyond the elementary school age group - may be candidates for talk-based therapies similar to those employed with children and adults with mental health disorders, such as anxiety (e.g., cognitive behavioral therapy, CBT). While talk-based therapies are widely used in community settings for school-aged youth and adults with ASD (Hess et al. 2008), the evidence base for using many such treatments is surprisingly weak. Compared to other types of intervention in autism (e.g., applied behavior analysis for young children) and interventions for other types of neurodevelopmental disorder (e.g., attention deficit/hyperactivity disorder, ADHD), there are very few well-designed studies of CBT and other talk-based therapies for individuals with autism. Of those studies that have been conducted, results are mixed, requiring a careful comparative analysis of the extant treatment literature to distinguish potentially promising practices from those that are less promising. This chapter endeavors to provide such an analysis and, in so doing, to draw preliminary conclusions about worthwhile practices currently available for implementation, as well as to identify directions for further development of treatment techniques. © 2011 Springer Science+Business Media, LLC.