Parent-Led Cognitive Behavioral Teletherapy for Anxiety in Autistic Youth: A Randomized Trial Comparing Two Levels of Therapist Support

Authors

Andrew G Guzick
Sophie C Schneider
Minjee Kook
Julia Rose Iacono
Saira A Weinzimmer
Troy Quast
Sean M Olsen
Killian Rainey Hughes
Emily Jellinek-Russo
Amanda Perozo Garcia
Abigail Candelari
Leandra N Berry
Robin P Goin-Kochel
Wayne K Goodman
Eric A Storch

Publication Date

5-1-2024

Journal

Behavior Therapy

DOI

10.1016/j.beth.2023.08.008

PMID

38670664

PMCID

PMC11055980

PubMedCentral® Posted Date

5-1-2025

PubMedCentral® Full Text Version

Author MSS

Published Open-Access

yes

Keywords

Humans, Cognitive Behavioral Therapy, Male, Female, Adolescent, Child, Parents, Anxiety Disorders, Telemedicine, Autistic Disorder, Treatment Outcome, Anxiety, Patient Satisfaction, Mental Health Teletherapy. Autism spectrum disorder, ASD, Cognitive behavioral therapy, CBT, Children

Abstract

Parent-led cognitive behavioral therapy (CBT) is an efficient, promising form of therapy that may be well suited for autistic youth with anxiety disorders, though to date it has been minimally tested. In this study, 87 autistic youth (7 to 13 years old) with anxiety disorders and their parents were randomized to two forms of parent-led CBT in which parents led their child through a guided CBT workbook across 12 weeks: one with low therapist contact (four 30-minute telehealth calls), and one with standard therapist contact (ten 60-minute telehealth calls). Anxiety, functional impairment, and autism features significantly declined across therapy, without differences between groups. High satisfaction was reported in both groups, though significantly higher satisfaction ratings were reported in standard-contact CBT. Responder rates were 69% of completers at posttreatment (70% in standard contact, 68% in low contact) and 86% at 3-month follow-up (86% in standard contact, 87% in low contact). Low-contact CBT was estimated to incur an average cost of $755.70 per family compared with $1,978.34 in standard-contact CBT. Parent-led CBT with minimal or standard therapist contact both appear to be effective CBT delivery formats for autistic youth with anxiety disorders, with significant cost savings for low-contact CBT.