Group Treatment for Adults with ASD: What’s the evidence?

When children with ASD are in the early stages of life, they might receive ABA therapy services to help support their behavior challenges at their young age. As these children grow, they might join a social skills group or receive individual therapy to support the challenges they experience in their older age. Once these children reach adulthood, the number of supports and the variety of supports available begin to trickle off. To date, few evidence-based practices exist to support adults with autism (National Autism Center, 2015). Even fewer group-based programs are available to support these adults. This blog will highlight what evidence-based practices are available, and what elements of group-based therapy are found to best support adults with autism. 

According to the National Standards Project conducted by the National Autism Center in 2015, there is one established treatment for adults with ASD – behavioral interventions. An established intervention is one backed by sufficient evidence and which is shown to produce favorable treatment outcomes. Examples of behavioral interventions include prompting, extinction, differential reinforcement of incompatible behavior, choice, and functional communication training. Behavioral interventions are meant for the individual, so no group interventions for adults with ASD are yet to be established, according to their study. Overall, there is a lack of research on group interventions for adults with ASD. 

Cognitive Behavioral Therapy

Cognitive behavioral approaches are a popular and effective treatment for individuals facing many types of mental health challenges. CBT is also shown to be effective with individuals in the autism community (Hesselmark, Plenty, Bejerot, 2013). In particular, five intervention elements that are shown to be effective when working with individuals with ASD include working in a group setting, structure and predictability, psychoeducation, social training, and CBT techniques. Group settings are beneficial because they provide space for social interactions and sharing, they reduce social isolation, they allow individuals to share and reflect on common experiences, thereby normalizing their experiences, and they provide a space for individuals to practice new social skills that they may learn (Hesselmark, Plenty, Bejerot, 2013; Spain, Blainey, 2015). CBT asks participants to think about situations from a new perspective, a skill that can be helpful for those with ASD. Overall, these skills may be beneficial to an individual, particularly those on the autism spectrum. 

Social Skills Interventions

Social skills interventions (SSI) overall can be helpful to those with ASD who may experience challenges in social communication. Overall, social skill interventions aim to improve social communication impairments, relationship skills, emotion recognition and regulation skills, and problem-solving abilities (Spain & Blainey, 2015). Some studies even show that combining CBT for social interaction with anxiety treatments can support individuals with ASD by reducing symptoms of social anxiety in group settings, providing a space for participants to test their social skills, and increased social knowledge. 

Another group intervention for individuals with ASD is the PEERS program for young adults. Based off of a group social skills training program for adolescents, this program aims to support individuals in learning skills to make and maintain friends. Based on results in the study conducted by Laugeson et al., individuals who participated in their group showed improvements in their social skills, frequency of social engagement, social skills knowledge, and reduced ASD symptoms related to social responsiveness (2015). 

Summary

Overall there appears to be many benefits to group treatments for individuals with Autism. When an individual turns 18, their symptoms do not suddenly disappear, and neither should their treatment options. 

 

Resources

Hesselmark, E., Plenty, S., & Bejerot, S. (2014). Group cognitive behavioural therapy and group recreational activity for adults with autism spectrum disorders: A preliminary randomized controlled trial. Autism, 18(6), 672-683.

Laugeson, E. A., Gantman, A., Kapp, S. K., Orenski, K., & Ellingsen, R. (2015). A randomized controlled trial to improve social skills in young adults with autism spectrum disorder: The UCLA PEERS® program. Journal of Autism and Developmental Disorders, 45(12), 3978-3989.

National Autism Center. (2015). Findings and conclusions: National standards project, phase 2. 

Randolph, MA: Author Scarpa, A., White, S. W., & Attwood, T. (Eds.). (2013). CBT for children and adolescents with high-functioning autism spectrum disorders. Guilford Press.

Spain, D., & Blainey, S. H. (2015). Group social skills interventions for adults with high-functioning autism spectrum disorders: A systematic review. Autism, 19(7), 874-886.

Spain, D., Blainey, S. H., & Vaillancourt, K. (2017). Group cognitive behaviour therapy (CBT) for social interaction anxiety in adults with autism spectrum disorders (ASD). Research in Autism Spectrum Disorders, 41, 20-30.