Factors Influencing the Use of Cognitive-Behavioral Therapy with Autistic Adults: A Survey of Community Mental Health Clinicians.
Brenna B Maddox, Samantha R Crabbe, Jessica M Fishman and 5 others
PMID 31385175WHAT IT FOUND
Community mental health clinicians said they were much less likely to start CBT with autistic adults than with adults without autism.
Their own attitudes about CBT were the main factor linked to intention.
Key findings
01Clinicians were much less willing to start CBT with autistic adults: 52% were quite or extremely likely for adults without autism, compared with 20% for autistic adults.
02Attitudes were the only factor that predicted intentions to start CBT for both adults without autism and autistic adults.
03Most clinicians had no autistic adults on their caseload (70%) and no formal training in working with autistic adults (76%).
STILL TO COME
How it was doneWhat they found
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What it does not show
The survey was done in one Northeastern urban area and among agencies involved in CBT initiatives, so it may not apply to other states, countries, or health systems. Clinicians chose whether to complete the survey, so their views may not represent all community mental health clinicians. It measured what clinicians said they intended to do, not what they actually did with patients. Most participants had little direct autism experience or formal training, which may shape their attitudes but does not show how CBT should be adapted. Some key measures used only one item, and the survey did not assess clinicians' knowledge of the evidence base or what treatments they chose instead. Because background questions came after the main survey, the researchers could not compare clinicians who dropped out with those who completed it.
Declared interests
The authors declared no conflict of interest.
The easy way to misread this
Do not read this as evidence that CBT helps or fails autistic adults. The survey measured clinicians' reported intentions to start CBT, not patient outcomes.