'It's not always textbook social anxiety': A survey-based study investigating the nature of social anxiety and experiences of therapy in autistic people.

The sample was skewed towards educated white women, so findings may not generalize to other demographic groups or to autistic people with learning disabilities or children. The study relied on self-reported data from a single survey, so the details of therapy experiences could not be verified or clarified. The 'distinct' model of social anxiety is an initial exploration and has not yet been validated in an independent sample. Few participants described positive therapy experiences, which limits the generalizability of the findings on what makes therapy helpful.

The authors declared no potential conflicts of interest and received no financial support for the research.

Do not assume that all autistic adults with social anxiety will benefit from modified CBT. The study found that most autistic participants who tried CBT found it unhelpful or even harmful because it invalidated their experiences. Therapists should not automatically apply standard CBT protocols without first assessing whether the client's social fears are grounded in real-world discrimination or sensory needs, as challenging these as 'irrational' can damage the therapeutic relationship.