The Relationship Between Treatment Acceptability and Youth Outcome in Group CBT for Youth with ASD and Anxiety

Anxiety is one of the most common co-occurring diagnoses in youth with autism spectrum disorder (ASD). Cognitive behavior therapy (CBT) is an evidence-based treatment that has been tailored for youth with ASD and anxiety and has shown good efficacy in reducing youth anxiety immediately after treatment. One area that has not been widely studied is acceptability of CBT for anxiety in this population. Acceptability includes beliefs about the potential helpfulness and satisfaction with a given treatment and may be important in understanding treatment outcomes. This study focuses on parent, youth, and clinician acceptability of a well-researched CBT program, Facing Your Fears, for youth with ASD and anxiety. Data was collected as part of a larger multi-site study that compared three different instructional conditions for clinicians learning the intervention. Results indicated that parents rated acceptability as higher for the overall treatment compared to youth. Further, youth and parents rated exposure related sessions as more acceptable than psychoeducation, and higher exposure acceptability ratings were predictive of lower youth anxiety levels post-treatment. Clinicians who received ongoing consultation rated treatment acceptability lower than clinicians in the other training conditions. While some clinicians may be hesitant to implement exposure techniques with this population, findings suggest that it is the technique that parents and youth rated as the most acceptable. Results are discussed in terms of treatment and research implications for youth with ASD and their families.