The use of cognitive behavioural therapy for adults with autism spectrum disorders: a review of the evidence

DOIhttps://doi.org/10.1108/MHRJ-05-2013-0017
Published date21 June 2013
Pages93-104
Date21 June 2013
AuthorJames Binnie,Sarah Blainey
Subject MatterHealth & social care
The use of cognitive behavioural therapy
for adults with autism spectrum disorders:
a review of the evidence
James Binnie and Sarah Blainey
James Binnie and Sarah
Blainey are both based at
Bromley Working for
Wellbeing, Bromley
Healthcare, Beckenham, UK.
Abstract
Purpose – There is a large and increasing evidence base for cognitive behavioural therapy (CBT) for the
amelioration of common mental health difficulties. In children and young people with autism, there is
some evidence that CBT can be effective; however, it is unclear whether this also applies to adults with
autistic spectrum disorders (ASDs). This review aimed to evaluate the evidence for the use of CBT with
adults with ASDs in relation to reducing comorbid psychiatric symptoms and increasing social and
communication skills.
Design/methodology/approach – A systematic search was conducted to identify best evidence.
Comparison to predetermined inclusion and exclusion criteria identified seven relevant studies; these were
subsequently critically appraised.
Findings – The results of the appraisal were mixed with no definitive evidence supporting the
review question.
Practical implications – Basing assumptions on best evidence, it is suggested that CBT can help adults
with ASDs decrease comorbid psychiatric symptomatology. However, there is little evidence that CBT can
increase social and communicative functioning. The review concludes that there is a need for increased
quantitative research in this area so that more substantial conclusions can be made.
Originality/value – This paper summarises the available evidence in relation to CBT for adults with ASD;
most previous review papers have focused on children and young people. Future research directions are
suggested.
Keywords Cognitive behavioural therapy, Autism spectrum disorders, Systematic review, Adults,
Psychiatry
Paper type Literature review
1. Background and rationale
Autism spectrum disorders (ASDs) are a group of neurodevelopmental syndromes diagnosed
where a person presents with a triad of impairments in social interaction, social communication,
and limited flexibility (American Psychiatric Association, 2004). Prevalence rates of ASD have
been reported to have risen over recent years; from 4.8 per 10,000 (Wing et al., 1976) to 20
per 10,000 (Chakrabarti and Fombonne, 2001). Current consensus is that the prevalence rate
has increased due to better recognition and detection (First and Tasman,2004). While ASD and
learning disability often co-occur, about 20-25 per cent of individuals with ASD do not meet
learning disability criteria (Fombonne, 1999), and generally have a higher level of functioning in
terms of activities of daily living, social and cognitive ability. The focus of this review is those
people who meet criteria for an ASD but do not have a learning disability, as this is most likely to
reflect the clients seen in routine primary care mental health practice. For the purposes of this
review, high-functioning autism (HFA) and Asperger’s syndrome (AS) are considered to be
the diagnostic labels most likely to be encountered in routine practice. These encompass
DOI 10.1108/MHRJ-05-2013-0017 VOL. 18 NO. 2 2013, pp. 93-104, CEmerald Group Publishing Limited, ISSN 1361-9322
j
MENTAL HEALTH REVIEW JOURNAL
j
PAGE 93

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