Ekman Elizabeth, Hiltunen Arto J
Department of Social and Psychological Studies, Section of Psychology, Karlstad University, Sweden.
Scand J Psychol. 2015 Dec;56(6):641-8. doi: 10.1111/sjop.12255.
In recent studies it has been suggested that Cognitive Behavior Therapy (CBT) is beneficial to people with Autism Spectrum Disorder (ASD) but that the method needs to be modified in relation to their cognitive profile. The aim of this study is to measure the effect of modified CBT, that is, using visualized language throughout the entire session for clients with ASD and anxiety and avoidance behavior. The modification of CBT in this study consists of focusing on CBT protocols for anxiety disorders and depression, while visualizing and systematizing "the invisible" in the conversation, in order for the clients to understand the social, cognitive and emotional context of self and others and how they should interact to avoid misunderstandings. ASD clients may need help to detect the invisible code of social interaction and communication. The level of anxiety and the frequency of target behavior were measured. Four assessments were made, two at the pre-assessment, and one in mid-therapy and end of therapy respectively. Generally, results suggest no improvement during pre-treatment period but a significant improvement during treatment. The values of the clients' psychological, social and occupational ability to function improved on the Global Function Rating scale. The preliminary conclusion of this pilot study indicates that the use of visualized language throughout the CBT therapy sessions is a promising modification of current CBT protocols for individuals with ASD. After manualization, larger studies with randomized controlled study designs can replicate or challenge these results.
最近的研究表明，认知行为疗法（CBT）对自闭症谱系障碍（ASD）患者有益，但该方法需要根据他们的认知特征进行调整。本研究的目的是测量改良版CBT的效果，即在整个治疗过程中为患有ASD以及伴有焦虑和回避行为的患者使用可视化语言。本研究中CBT的改良包括专注于针对焦虑症和抑郁症的CBT方案，同时在对话中将“无形的东西”可视化并系统化，以便患者理解自我和他人的社会、认知和情感背景，以及他们应该如何互动以避免误解。ASD患者可能需要帮助来发现社交互动和沟通中的无形代码。测量了焦虑水平和目标行为的频率。进行了四次评估，两次在预评估时，另外一次分别在治疗中期和治疗结束时。总体而言，结果表明治疗前期没有改善，但治疗期间有显著改善。在全球功能评定量表上，患者的心理、社会和职业功能能力值有所提高。这项初步研究的初步结论表明，在整个CBT治疗过程中使用可视化语言是对当前针对ASD个体的CBT方案的一种有前景的改良。在形成手册后，采用随机对照研究设计的更大规模研究可以复制或挑战这些结果。
