scholarly journals Evaluation of radically open dialectical behaviour therapy in an adult community mental health team: effectiveness in people with autism spectrum disorders

2020 ◽  
pp. 1-8
Author(s):  
Peter L. Cornwall ◽  
Susan Simpson ◽  
Claire Gibbs ◽  
Valerie Morfee
Keyword(s):  
Autism Spectrum Disorders ◽  
Autism Spectrum ◽  
Medium Effect ◽  
Behaviour Therapy ◽  
Dialectical Behaviour Therapy ◽  
Transdiagnostic Treatment ◽  
Distress Score ◽  
Medium Effect Size ◽  
Spectrum Disorders ◽  
Global Distress

Aims and method Radically open dialectical behaviour therapy (RO DBT) is a transdiagnostic treatment designed to address disorders associated with overcontrol, including autism spectrum disorders (ASD). To date, no studies have reported on the effectiveness of RO DBT for people with ASD. Forty-eight patients were referred to a RO DBT programme, of whom 23 had a diagnosis of ASD. Outcome was measured using the Clinical Outcomes in Routine Evaluation – Outcome Measure (CORE) and the Questionnaire about the Process of Recovery. Results The intervention was effective, with a medium effect size of 0.53 for improvement in CORE global distress. End-point CORE global distress score was predicted from initial severity and a diagnosis of ASD. Participants with a diagnosis of ASD who completed the therapy had significantly better outcomes than completing participants without an ASD diagnosis. Clinical implications These findings provide preliminary support for RO DBT as an effective intervention for ASD in routine settings.

scholarly journals How to Optimise Cognitive Behaviour Therapy (CBT) for People with Autism Spectrum Disorders (ASD): A Delphi Study

2019 ◽  
Vol 38 (2) ◽  
pp. 184-208 ◽  
Author(s):  
Debbie Spain ◽  
Francesca Happé
Keyword(s):  
Autism Spectrum Disorders ◽  
Delphi Study ◽  
Cognitive Behaviour Therapy ◽  
Outcome Measurement ◽  
Autism Spectrum ◽  
Behaviour Therapy ◽  
Adults With Autism ◽  
Cognitive Behaviour ◽  
Spectrum Disorders ◽  
Neuropsychological Impairments

AbstractChildren and adults with autism spectrum disorders (ASD) can benefit from cognitive behaviour therapy (CBT), yet the prevailing opinion is that this requires adaptations to accommodate commonly experienced socio-communication and neuropsychological impairments. There are, however, no empirically-derived guidelines about how best to adapt standard practice. In a three round Delphi survey, we asked expert clinicians and clinical-researchers, based in England, about how to optimise the design, delivery and evaluation of CBT for people with ASD. Of 50 people approached, 18 consented to take part in Round 1, nine in Round 2 and eight in Round 3. Using a five-point scale, participants rated the degree to which 221 statements—pertaining to the referral process, assessment, engagement, formulation, goal setting, therapy structure, interventions and techniques, homework, outcome measurement, managing endings and therapist attributes—were integral to CBT. The consensus was that 155 statements represented essential or important components of CBT. Adaptations to the structure and process of therapy were consistently endorsed, and an individualised formulation-derived approach was favoured when deciding upon which interventions and techniques to offer. Further studies are needed to clarify if adapted CBT is associated with improved treatment outcomes and acceptability.

Enhancing self-esteem in adults with autism spectrum disorders: a pilot cognitive behaviour therapy (CBT) group intervention

2017 ◽  
Vol 3 (2) ◽  
pp. 66-75 ◽  
Author(s):  
Debbie Spain ◽  
Sarah H. Blainey
Keyword(s):  
Autism Spectrum Disorders ◽  
Group Intervention ◽  
Cognitive Behaviour Therapy ◽  
Self Esteem ◽  
Autism Spectrum ◽  
Behaviour Therapy ◽  
Content Type ◽  
Cognitive Behaviour ◽  
Spectrum Disorders ◽  
Adults With Asd

Purpose Psychosocial risk factors and high rates of psychiatric comorbidity render individuals with autism spectrum disorders (ASD) vulnerable to developing low self-esteem (LSE). Cognitive behaviour therapy (CBT) interventions are effective for enhancing self-esteem in typically developing populations, but the degree to which they are clinically beneficial for individuals with ASD has been little explored. The paper aims to discuss these issues. Design/methodology/approach A pilot group intervention was undertaken to investigate the effectiveness and acceptability of CBT for LSE in adults with ASD. Adaptations to standard protocols were made, in order to accommodate core ASD characteristics. Findings Four participants attended eight sessions: these comprised formulation of causal and maintaining mechanisms for LSE, cognitive interventions designed to reduce self-criticism and promote a more balanced self-view, and behavioural interventions intended to increase engagement in enjoyable activities, and enhance problem-solving skills and assertiveness. Self-report questionnaires were completed at four time points: baseline, at the first and last sessions, and at one-month follow-up. Data analysis indicated no change in the primary self-esteem outcome measure. Some improvements were noted on secondary outcomes, specifically in social anxiety and depressive symptoms, and general functioning. Research limitations/implications Further studies are needed to determine how to design and deliver CBT interventions and techniques which target LSE in individuals with ASD. Originality/value This is one of the first CBT group interventions designed to address LSE in adults with ASD.

Psychological interventions for adults with autism spectrum disorders: a review

2015 ◽  
Vol 1 (2) ◽  
pp. 79-86 ◽  
Author(s):  
Debbie Spain ◽  
Laura Harwood ◽  
Lucy O'Neill
Keyword(s):  
Mental Health ◽  
Autism Spectrum Disorders ◽  
Autism Spectrum ◽  
Psychological Interventions ◽  
Behaviour Therapy ◽  
Treatment Protocols ◽  
Content Type ◽  
Cognitive Behaviour ◽  
Spectrum Disorders ◽  
The Impact

Purpose – Adults who have autism spectrum disorders (ASD) experience a range of core and co-morbid characteristics which impede daily functioning and quality of life. Children and adolescents with ASD derive clinically meaningful benefits from psychological interventions, including those designed to reduce socio-communication deficits and mental health conditions. Relatively little is known about the effectiveness of these interventions for the adult ASD population. The paper aims to discuss this issue. Design/methodology/approach – A selective search of English language, peer-reviewed publications was undertaken, in order to summarise the empirical data pertaining to psychological interventions for adults with high-functioning ASD (HF-ASD). Findings – Thus far, social skills interventions, cognitive behaviour therapy techniques, and mindfulness-based approaches have been researched most extensively. Interventions have primarily sought to: reduce the impact of core ASD characteristics; enhance skills; and improve co-morbid mental health symptoms. Methodological and clinical heterogeneity render it difficult to generalise study findings across population samples, but overall, interventions appear to be associated with reductions in co-morbid symptom severity, and improved functioning. Research limitations/implications – Further studies that seek to improve functioning, reduce co-morbid characteristics, and enhance the propensity for attaining and maintaining independence are now needed. Practical implications – Adaptations to standard treatment protocols are likely required in order to enhance engagement and optimise treatment gains. Originality/value – This is one of the first reviews to focus specifically on psychological interventions for adults with HF-ASD.

Effectiveness of a modified dialectical behaviour therapy for adolescents within a stepped-care model

2016 ◽  
Vol 30 (2) ◽  
Author(s):  
Sarosh Khalid-Khan ◽  
Shira C. Segal ◽  
Ellen N. Jopling ◽  
Kathy Southmayd ◽  
Patricia Marchand
Keyword(s):  
Personality Disorder ◽  
Effect Size ◽  
Stepped Care ◽  
Medium Effect ◽  
Care Model ◽  
Behaviour Therapy ◽  
Emotional Symptoms ◽  
Dialectical Behaviour Therapy ◽  
Medium Effect Size ◽  
Disruptive Behaviours

Abstract Objective: Early intervention with evidence-based treatment is important to halt the progression from early manifestations of personality disorder traits to adult personality disorders. The purpose of this study is to evaluate dialectical behaviour therapy (DBT) modified for an adolescent population with borderline personality disorder (BPD), offered within a stepped-care model. Methods: Seven adolescents (M=1, F=6, Mage=16.86) diagnosed with either BPD or BPD traits participated in a modified 15-week DBT group. The group was offered within a stepped-care model, which required participants to have previously completed an 8-week distress-tolerance module. Pre/post scores on self-report measures of BPD symptomatology, including impulse control, emotional regulation and awareness, anxiety, depression, and substance use, were collected. Results: Participants showed a post-treatment decrease in anxiety symptoms (large effect size) and disruptive behaviours (medium effect size). There was also an increase in emotional symptoms (medium effect size) and hyperactivity/inattention (medium effect size). Conclusion: The modified DBT group shows promise in alleviating symptoms of anxiety and some of the disruptive behaviours associated with BPD. The increase in emotional symptoms may be due to the expressive nature of DBT, and may contribute to their eventual therapeutic processing in the next step of the program.

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