Cognitive Behaviour Therapy Versus a Counselling Intervention for Anxiety in Young People with High-Functioning Autism Spectrum Disorders: A Pilot Randomised Controlled Trial.
Suzanne M Murphy, Uttom Chowdhury, Susan W White and 8 others
PMID 28770527WHAT IT FOUND
For young people with high-functioning autism and anxiety, cognitive behaviour therapy (CBT) was no more effective than person-centred counselling at reducing anxiety symptoms.
Neither treatment showed superiority over the other on primary anxiety measures or social skills outcomes.
Key findings
01There were no significant differences between CBT and counselling on primary anxiety outcomes (ADIS and CASI-anx) at immediate post-test or 12-week follow-up.
02Participants in the counselling arm attended significantly more individual sessions than those in the CBT arm, though therapeutic alliance scores were similar between the two groups.
03Secondary outcomes for social skills (measured by the Social Responsiveness Scale) showed no significant differences between the two treatments at either time point.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
The study was a pilot with a very small sample size (36 participants), limiting the power to detect subtle differences between treatments. Attrition was high for teacher-reported measures at follow-up (over 50%), reducing the reliability of social skills data from this source. The significant finding for separation anxiety at post-test was based on a very small number of participants (9 out of 36) meeting the diagnostic criteria, making it prone to chance. The counselling intervention was delivered in an NHS setting, but the specific adherence to person-centred therapy principles was measured via video ratings which showed moderate agreement for the counselling scale, potentially affecting the precision of fidelity checks. The sample had a higher proportion of girls than is typical in autism research, which may affect generalisability.
Declared interests
The study was funded by South Essex Partnership NHS Foundation Trust. No specific conflicts of interest for the authors were declared in the provided text.
The easy way to misread this
Do not conclude that counselling is superior to CBT based on the significant difference in separation anxiety scores. This finding involved only nine participants who met the diagnosis at baseline, and the authors explicitly state it should be interpreted with extreme caution due to the small subgroup size.