Factors Influencing the Use of Cognitive-Behavioral Therapy with Autistic Adults: A Survey of Community Mental Health Clinicians

J Autism Dev Disord. 2019 Nov;49(11):4421-4428. doi: 10.1007/s10803-019-04156-0.

Abstract

Cognitive-behavioral therapy (CBT) can improve anxiety and depression in autistic adults, but few autistic adults receive this treatment. We examined factors that may influence clinicians' use of CBT with autistic adults. One hundred clinicians completed an online survey. Clinicians reported stronger intentions (p = .001), more favorable attitudes (p < .001), greater normative pressure (p < .001), and higher self-efficacy (p < .001) to start CBT with non-autistic adults than with autistic adults. The only significant predictor of intentions to begin CBT with clients with anxiety or depression was clinicians' attitudes (p < .001), with more favorable attitudes predicting stronger intentions. These findings are valuable for designing effective, tailored implementation strategies to increase clinicians' adoption of CBT for autistic adults.

Keywords: Adults; Autism spectrum disorder; Cognitive–behavioral therapy; Community mental health; Implementation science; Theory of planned behavior.

MeSH terms

  • Adult
  • Anxiety / psychology
  • Attitude of Health Personnel*
  • Autistic Disorder / psychology
  • Autistic Disorder / therapy*
  • Cognition
  • Cognitive Behavioral Therapy / statistics & numerical data*
  • Community Health Workers / psychology*
  • Community Mental Health Services / statistics & numerical data*
  • Depression / psychology
  • Female
  • Humans
  • Intention
  • Male
  • Middle Aged
  • Self Efficacy
  • Surveys and Questionnaires
  • Treatment Outcome