Caregiver Satisfaction with Anxiety Treatment for Autistic Youth: A Mixed Methods Examination

For Cognitive Behavioral Therapy to best meet the specific needs of autistic youth with co-occurring anxiety and to continue to grow as a sustainable treatment option, it is important to incorporate caregiver perspectives and feedback. Data were drawn from a randomized controlled trial and included 148 caregivers of autistic youth (ages 7-13 years, M = 9.89, SD = 1.79; 23% female; 77.7% White) with co-occurring anxiety disorders randomized to one of two active treatment conditions (Coping Cat, n = 72, or Behavioral Interventions for Anxiety in Children with Autism [BIACA], n = 76). A systematic inductive thematic analysis was used to code open-ended parent responses on the Consumer Satisfaction Questionnaire to identify what caregivers of autistic children with co-occurring anxiety liked most and least about their child's treatment. Satisfaction with treatment was high (M = 64.98, SD = 5.48). Caregivers' most-liked treatment features across treatments included (a) tools and coping skills, (b) therapeutic alliance, (c) caregiver support and involvement, (d) personalized treatment, and (e) treatment efficacy. Least-liked features of treatment and family participation included (a) the commute to the clinic, (b) treatment length, (c) commitment required at home, (d) questionnaires, and (e) scheduling. Treatment responders endorsed therapeutic alliance more frequently. Caregivers in BIACA endorsed caregiver support and involvement at higher rates, in addition to commitment required at home. Caregiver responses indicated a preference for more sessions and highlighted the importance of balancing need for caregiver involvement in treatment while reducing caregiver burden.