Friday, 5 April 2019

CBT for anxiety in kids with autism meta-analysed

A short post today to bring the findings reported by Celal Perihan and colleagues [1] to your attention with regards to the use of cognitive behavioural therapy (CBT) for anxiety in the context of paediatric autism.

It was yet another case of authors meta-analysing (boiling down) the data from the existing research literature and coming to a conclusion. Twenty-odd studies reported on the use of CBT - talking therapy - for an important quality-of-life draining issue for many diagnosed on the autism spectrum: anxiety (see here and see here). Researchers concluded that CBT did seem to be associated with a reduction in some anxiety-linked symptoms/behaviours but things weren't altogether cut-and-dried on the usefulness of CBT in this context.

I wasn't surprised by these results. I've blogged before about how CBT for anxiety in the context of autism might be a useful option for some (see here). That being said, I'm not 100% in favour of CBT being used in this context. I say that because, as things stand, we don't know enough about why anxiety seems to be over-represented in relation to autism (see here). I've opined on various occasions that anxiety is probably a lot more than 'just a comorbidity' when it comes to some autism (see here). In that context, the use of CBT 'for anxiety' is a little bit like saying that CBT is being used 'for autism'. And the evidence for that is pretty unconvincing (see here).

If you really want to convince me that CBT is good for anxiety in the context of autism, try pitting CBT against some of the other non-psychology interventions that have been talked about for anxiety in relation to autism (see here). See what comes out on top rather than just looking at CBT vs. treatment-as-usual (whatever that means). Oh, and bear in mind that we still don't know enough about the presentation of anxiety in those on the autism spectrum who are perhaps not able to participate in CBT (see here)...

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[1] Perihan C. et al. Effects of Cognitive Behavioral Therapy for Reducing Anxiety in Children with High Functioning ASD: A Systematic Review and Meta-Analysis. J Autism Dev Disord. 2019. Feb 27.

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