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“Less stress”: a pilot study on a cognitive behavioral treatment program for anxiety in children with autism spectrum disorders

Open Access
|Mar 2021

Figures & Tables

Comparing baseline values for completers and non-completers

Age yearsIQCGASSRSRCADSNumber of anxiety diagnosesComorbid ADHD
Non-completers (n = 2)9.59951t = 71t = 83n = 1 in both1 of 2
Completers (n = 8)9.58840t = 96t = 97Range 1-5, mean 26 of 8

Therapist rated adherence and competence

Items rated by the therapist after every sessionMean (SD) range
1. To what extent did you follow the specified structure for the session?3.5 (0.5) 2-4
2. To what extent did you demonstrate your therapeutic process and relationship skills?3.5 (0.4) 2-4
3. To what extent did you think you focused on the goals set for the session?3.5 (0.3) 2-4
4. Based on an overall assessment, how competently did you experience yourself as a therapist this session?3.4 (0-5) 2-4

User satisfaction rated by parents and children

MotherFatherChild
ItemsMean (SD)Mean (SD)Mean (SD)
I found the” Less Stress” program useful7.0 (0.0)6.6 (0.5)6.1 (0.8)
I have used some of what I learned during the program6.9 (0.4)5.4 (0.9)5.8 (0.9)
I liked the “Less Stress” program6.8 (0.5)6.4 (0.5)5.8 (2.1)
I will continue to use what I learned in the program6.8 (0.5)6.0 (0.7)5.9 (0.8)
I remember what I learned in the program6.4 (0.7)5.3 (0.5)5.5 (0.8)
Did you talk to your child/parent about “Less Stress”? (yes = 1 / no = 0)1.0 (0.0)0.6 (0.5)0.9 (0.4)
Were you content with the therapist?8.8 (0.5)8.4 (0.5)7.9 (1.8)

Questionnaire ratings at baseline and after treatment

Questionnaires, ratersBaseline ratings N=10After treatment N=8Statistics
Mean (SD) rangeMean (SD) ranget-value p-value
CGAS, clinician-rated42.4 (6.9) 32-5248.3 (3.8) 41-55-3.85< .01
SRS t-score, mother91.1 (12.6) 62-10985.9 (11.0) 64-1033.03.02
RCADS t-score, mother94.6 (11.0) 74-11873.2 (20.1) 50-1104.25< .01
RCADS t-score, father96.2 (16.3) 76-11575.6 (17.9) 53-1122.73.04
RCADS t-score, child67.0 (16.0) 38-8260.0 (12.7) 43-764.06.01
ILC total score, child16.6 (4.4) 9-2118.9 (3.6) 13-24-2.24.07
ILC PR score, child3.6 (1.5) 2-63.0 (1.7) 0-51.66.16
CALIS raw score, mother50.1 (6.0) 39-5941.8 (10.3) 20-532.16.07
CALIS raw score, father45.4 (6.7) 37-5537.6 (12.8) 20-591.65.16

Overview of the “Less Stress” sessions

SessionContent
Parent session 1Conducted before session 1. Parents receive information regarding the program and the role of the parent during the treatment
Session 1“Getting to know each other” exercise. Introduction to the program, assessment of the child’s interests and what makes the child happy. Assessment of potential rewards that could be used
Session 2Psychoeducation on feelings, relaxation and anxiety. Setting goals for the program
Session 3Creating a toolbox for emotion regulation (”Relaxation tools” and “Special interest tools” based on sessions 1 and 2, and introduction to “Physical tools”, “Social tools”, “Other tools” and “Unhelpful tools”)
Session 4“Thinking tools” (cognitive restructuring) and “Doing-tools” (exposure)
Session 5“Thinking tools” and “Doing-tools”
Session 6“Problemsolving tools” + Exposure
Session 7“Completing the toolbox” + Exposure
Parent session 2Conducted before session 8: Update on progress/goal setting. Information regarding exposure work and role of the parents in the next treatment phase
Session 8-13Exposure-based targeting of the main anxiety problem(s)
Follow-up sessions 1-3Three follow-up sessions with a monthly interval (starting 1 month after session 13)
Language: English
Page range: 30 - 40
Published on: Mar 25, 2021
Published by: Psychiatric Research Unit
In partnership with: Paradigm Publishing Services
Publication frequency: 1 times per year

© 2021 Beate Oerbeck, Kristin Romvig Overgaard, Tony Attwood, Jon Fauskanger Bjaastad, published by Psychiatric Research Unit
This work is licensed under the Creative Commons Attribution 4.0 License.