One possible treatment option for anxiety among people with autism is Cognitive Behavior Therapy, or CBT. CBT was initially developed to treat depression in the general population, but is now being used to address additional needs. CBT focuses on changing negative and anxiety-producing thoughts and beliefs. CBT clients are taught to examine their emotions and thoughts, and recognize when negative emotions and thoughts are becoming more intense. They are also taught strategies to change their thinking, the premise being that this change in thought patterns can change the person's their behavior. CBT can be accompanied by other interventions including positive reinforcement and social stories.
While there are various components of CBT, many programs include the following. Initially, the client may be assured that they are not to blame for their anxiety. Once this is established, the therapist and client come to a consensus about how the anxiety is causing problems for the client (such as social anxiety preventing a person from attending events of interest). This can provide a rationale and motivation for the CBT program.
The client and therapist work together to create a list of situations that produce anxiety for the client. This list is ordered from most to least anxiety-producing. The client is taught coping methods (such as relaxation techniques and logical, more positive thinking patterns about the anxiety-producing situations). At the same time, the client is gradually exposed to the anxiety producing situations, staring with the least anxiety-producing.
CBT may be somewhat more challenging for a person with autism due to difficulty identifying feelings and thought patterns. This may be challenging for the general population as well, but it may be more so for a person with autism. Some methods for making CBT more autism-friendly might include using visual aides, explaining complex social issues using social stories, allowing the person with autism to type their responses to therapist questions (or using online chat to ask questions), and incorporating the client's special interests into therapy sessions. More explanation and application of CBT for individuals with autism can be found in these resources from Tony Attwood:
If you are interested in finding a cognitive behavior therapist, here are some tips: http://abct.org/docs/Members/FactSheets/Guidelines_for_Choosing_Cognitive.pdf
References:
"Treatment of Anxiety in Autism Spectrum Disorders Using Cognitive Behaviour Therapy: A Systematic Review" by Russell Lang, April Regester, Stacy Lauderdale, Kristen Ashbaugh, and Anna Haring. Developmental Neurorehabilitation, February 2010, Volume 13, Issue 1.
"Evidence-Based Practices for Children, Youth, and Young Adults with Autism Spectrum Disorder" by Connie Wong, Samuel L. Odom, Kara Hume, Ann W. Cox, Angel Fettig, Suzanne Kucharczyk, Matthew E. Brock, Joshua B. Plavnick, Veronica P. Fleury, and Tia R. Schultz http://autismpdc.fpg.unc.edu/sites/autismpdc.fpg.unc.edu/files/2014_EBP_Report.pdf
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