Cognitive behavioural therapy for anxiety in a man with Autism Spectrum Disorder, Intellectual Disability, and social phobia
| Published date | 09 September 2013 |
| Date | 09 September 2013 |
| DOI | https://doi.org/10.1108/AMHID-06-2013-0040 |
| Pages | 284-292 |
| Author | Kevin Paul Wright |
| Subject Matter | Health & social care,Learning & intellectual disabilities |
Cognitive behavioural therapy for anxiety
in a man with Autism Spectrum Disorder,
Intellectual Disability, and social phobia
Kevin Paul Wright
Dr Kevin Paul Wright is a
Clinical Psychologist, based at
Specialist Learning Disabilities
Service, Barnsley, UK.
Abstract
Purpose – This paper evaluates the effectiveness of cognitive-behavioural therapy (CBT) in the treatment of
social anxiety with a 19-year-old man with intellectual disabilities (ID) and autistic spectrum disorders.
Design/methodology/approach – The intervention was evaluated using an A-B single case design.
An idiosyncratic measure was developed to measure anxietysymptoms on a daily basis. The brief symptom
inventory (BSI; Derogatis, 1975) measured symptom patterns across nine psychological dimensions and
was administered at initial assessment, pre-intervention and post-intervention.
Findings – Visual and statistical analysis of the data showed that anxiety severity dramatically reduced
throughout the course of therapy, reaching and maintaining zero and this was statistically significant. Data
seemed to show that sudden gains in the reduction of anxiety severity occurred during the relaxation and
cognitive phases of intervention. This sudden gain coincided with an increase in daily activities, and
exposure to more anxiety provoking events which was also statistically significant. Global anxiety scores, as
measured by the BSI, showed a notable reduction at post-treatment.
Originality/value – This paper demonstrates that CBT can bring about meaningful improvements in the
treatment of anxiety in people with ID and autism and suggests that further exploration with the wider
population is needed.
Keywords Intellectual disabilities, Anxiety, Autism, Social phobia
Paper type Case study
Epidemiological studies report that approximately 35 per cent of the population of people who
have autistic spectrum disorders (ASD) suffer with anxiety disorders (e.g. Leyfer et al., 2006),
and it has been suggested that adults with autism are almost three times more anxious than
their non-autistic peers (Gillott, 2004). Anxiety disorders can be debilitating to individuals with
ASD (Greig and Mackay, 2005), often posing an additional barrier to their overall adjustment by
adversely affecting academic performance, peer relationships, and family functioning, and
exacerbating social skills deficits related to ASD (e.g. Bellini, 2004). However, whilst it is highly
likely that the social and communicative impairments which are central to ASD exacerbate
anxiety, and that anxiety disorders exacerbate the social difficulties and functional impairments
caused by ASD (Sze and Wood, 2007), there is currently a dearth in the literature regarding the
aetiology of anxiety amongst individuals with ASD, or aimed at developing effective treatments
(Leyfer et al., 2006). Therefore, efficacious treatments to address anxiety in populations with
ASD are needed (Leyfer et al., 2006). If successful treatments could be developed for this
population, they might also positively influence other aspects of functioning, such as social skills
which are adversely affected by anxiety.
One logical approach to the development of efficacious treatments for anxiety in ASD
populations is to turn to the decades of evidence-based psychotherapy research in typically
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ADVANCES IN MENTAL HEALTH AND INTELLECTUAL DISABILITIES
j
VOL. 7 NO. 5 2013, pp. 284-292, CEmeraldGroup Publishing Limited, ISSN 2044-1282 DOI 10.1108/AMHID-06-2013-0040
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