A randomized waitlist‐controlled trial of cognitive behavior therapy to improve emotion regulation in children with autism

Abstract

BackgroundMental health problems are common among individuals with autism spectrum disorder (ASD), and difficulties with emotion regulation processes may underlie these issues. Cognitive behavior therapy (CBT) is considered an efficacious treatment for anxiety in children with ASD. Additional research is needed to examine the efficacy of a transdiagnostic treatment approach, whereby the same treatment can be applied to multiple emotional problems, beyond solely anxiety. The purpose of the present study was to examine the efficacy of a manualized and individually delivered 10‐session, transdiagnostic CBT intervention, aimed at improving emotion regulation and mental health difficulties in children with ASD.MethodsSixty‐eight children (M age = 9.75, SD = 1.27) and their parents participated in the study, randomly allocated to either a treatment immediate (n = 35) or waitlist control condition (n = 33) (ISRCTN #67079741). Parent‐, child‐, and clinician‐reported measures of emotion regulation and mental health were administered at baseline, postintervention/postwaitlist, and at 10‐week follow‐up.ResultsChildren in the treatment immediate condition demonstrated significant improvements on measures of emotion regulation (i.e., emotionality, emotion regulation abilities with social skills) and aspects of psychopathology (i.e., a composite measure of internalizing and externalizing symptoms, adaptive behaviors) compared to those in the waitlist control condition. Treatment gains were maintained at follow‐up.ConclusionsThis study is the first transdiagnostic CBT efficacy trial for children with ASD. Additional investigations are needed to further establish its relative efficacy compared to more traditional models of CBT for children with ASD and other neurodevelopmental conditions.

Qualitative study of loneliness in a senior housing community: the importance of wisdom and other coping strategies

“…It is worth noting that wisdom is a potentially modifiable trait, as there are a number of studies with effective interventions for subcomponents of wisdom. There is evidence that psychosocial interventions can improve emotional regulation and compassion/empathy as well as spirituality (Kelly & Carter, 2015;Margolin, Beitel, Schuman-Olivier, & Avants, 2006;Weiss et al, 2018). For example, mindfulness-based stress reduction has been shown to improve self-compassion in medical students (Erogul, Singer, McIntyre, & Stefanov, 2014), while goal management training increased emotional regulation in adults with acquired brain injuries (Tornas, Lovstad, Solbakk, Schanke, & Stubberud, 2016).…”

Effectiveness of behavioral interventions for autism spectrum disorder: A systematic review

“…Communication-focused interventions was used in twenty one studies [15,21,26,31,46,50,51,54,55,66,67,75,76,82,91,[93][94][95]104]. Thirty-two studies used integrative programs [18,20,24,25,28,30,33,[35][36][37]40,52,58,60,62,63,71,74,[77][78][79]81,86,89,92,96,98,[100][101][102][103]107]. Also, thirty studies used social skills development interventions [16,17,…”

“…The results of the included studies were mainly based on observed data and only in fourteen studies, selfreported of participants' practices were used to evaluate the effects of interventions [23,34,40,45,58,61,64,65,70,72,77,79,100,101]. Of the included studies, only twelve (12.9%) used theories and models.…”

“…Three studies on social skills [18,20,89], three studies on emotional and communication skills [40,77,78], three studies on social behavior skills [58,60,98], two studies on daily living skills [24,37], and one study on social communication [103]. But, two studies reported that some of the expected outcomes created signi cant change [28,63], and in two studies, the intervention was not successful for changes [52,74].…”

Emotion regulation: A treatment target for autism spectrum disorder

“…It is also well documented that children with ASD experience significant difficulties in emotion identification, Bulletin of the Menninger Clinic expression, and regulation (Begeer, Koot, Rieffe, Terwogt, & Stegge, 2008;Cai, Richdale, Dissanayake, & Uljarević, 2018;Hepburn & Wolf, 2013;Joshi et al, 2018;White et al, 2013). However, until recently, difficulties with emotion regulation (ER) have not been a target of treatment in this population (Conner & White, 2018;Scarpa & Reyes, 2013;Weiss et al, 2018). In this article, we review the ER difficulties in individuals with ASD, highlight cognitive-behavioral therapy (CBT) and mindfulness-based interventions that have addressed ER skills in this population, and report on the initial efficacy achieved by these interventions.…”