Improving Cognitive Behaviour Therapy for Autistic Individuals: A Delphi Survey with Practitioners

Area of Science:

• Psychiatry
• Clinical Psychology
• Neurodevelopmental Disorders

Background:

• Cognitive Behaviour Therapy (CBT) is increasingly recognized for its effectiveness in addressing anxiety, depression, and obsessive-compulsive disorder in autistic individuals.
• However, less is understood about the implementation of CBT in routine clinical practice and potential areas for service improvement for this population.

Purpose of the Study:

• To identify barriers to the acceptability and effectiveness of CBT for autistic individuals in routine practice.
• To achieve consensus on strategies for enhancing CBT service provision and the autism-relevant training needs of CBT practitioners.

Main Methods:

• A three-round Delphi survey was conducted with 50 CBT practitioners.
• The survey aimed to gather expert perspectives on barriers, service improvements, and training requirements for delivering CBT to autistic individuals.

Main Results:

• Six key barriers were identified across service provision, practitioner, client, CBT-specific, national guideline, and systemic factors.
• Consensus was reached on five domains for improving the CBT care pathway: process, service provision, practitioners, techniques, and therapeutic approach.
• Essential training needs for practitioners include autism, CBT-specific issues, co-occurring conditions, and engagement strategies, alongside autism-relevant clinical supervision.

Conclusions:

• Significant barriers exist in delivering effective CBT to autistic individuals within routine practice.
• Adapting service provision and enhancing practitioner training, particularly in autism-specific knowledge and skills, are vital for improving care.
• Further research is necessary to evaluate the impact of these adaptations on the outcomes for autistic individuals receiving CBT.