Autistic adults’ experiences of cognitive-behavioural group therapy for social anxiety: Relational experiences of participation / Bruna B. ROISENBERG in Autism, 30-1 (January 2026)  

Public ISBD [article]  inAutism > 30-1 (January 2026) . - p.197-212 Titre : Autistic adults’ experiences of cognitive-behavioural group therapy for social anxiety: Relational experiences of participation Type de document : texte imprimé Auteurs : Bruna B. ROISENBERG, Auteur ; Kelsie A. BOULTON, Auteur ; Emma E. THOMAS, Auteur ; Nina PERRY, Auteur ; Dorothy YU, Auteur ; Adam J. GUASTELLA, Auteur Article en page(s) : p.197-212 Langues : Anglais (eng) Mots-clés : mental health  peer connection  psychological intervention  thematic analysis  treatment Index. décimale : PER Périodiques Résumé : Autistic adults often report high levels of social anxiety and significant life impacts from this anxiety on well-being and functioning. Although cognitive-behavioural therapy in group settings has been adapted for autistic populations, there is a paucity of research exploring how autistic individuals experience CBT interventions. This qualitative study investigated autistic adults’ experiences of a modified cognitive-behavioural therapy group programme for social anxiety. Twenty-seven autistic participants were recruited through clinical services and community outreach. Following the intervention, participants completed semi-structured individual interviews about their experience of the programme. Participants reported both therapeutic benefits and challenges following their participation. Themes included reflections on group dynamics, mental health impacts, social functioning and daily life applications of strategies. Peer connection emerged as a core facilitator of engagement, while structured strategies were credited with bolstering social confidence and self-awareness. However, challenges, such as sensory sensitivities, the role of previous therapeutic experiences and difficulties applying strategies beyond the therapy context, were also highlighted.Lay Abstract Autistic adults often report high levels of social anxiety. To support autistic people with social anxiety, we developed a group therapy programme, the Engage Program, an intervention designed specifically for autistic adults. Our study aimed to better understand what it is like for autistic adults to take part in group therapy and what aspects of the programme were most helpful, or not. The programme aimed to provide a safe space where participants could explore social interactions in a way that felt comfortable and authentic. Rather than encouraging people to hide or ‘camouflage’ their autistic traits, the programme focused on building confidence, self-understanding and meaningful connections with peers. Sessions included guided discussions, structured activities and shared experiences. We interviewed participants who had completed the group programme to hear directly from them about their experiences. Many said they felt less alone and more socially confident after taking part in the group. They appreciated connecting with others who understood their experiences, and they said this helped them feel more accepted and supported. They also reported that participating in the group helped them understand their social strengths and challenges more clearly. However, not everything worked for everyone. Some participants found aspects of the therapy challenging, especially if they had sensory sensitivities or difficult past experiences with therapy. In the future, we want to explore how to make group therapy more flexible and accessible, especially for those who may struggle in traditional settings. This research shows that group therapy can be a powerful way to support autistic adults, especially when it is designed with their needs and preferences in mind. En ligne : https://dx.doi.org/10.1177/13623613251377930 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=578 [article] Autistic adults’ experiences of cognitive-behavioural group therapy for social anxiety: Relational experiences of participation [texte imprimé] / Bruna B. ROISENBERG, Auteur ; Kelsie A. BOULTON, Auteur ; Emma E. THOMAS, Auteur ; Nina PERRY, Auteur ; Dorothy YU, Auteur ; Adam J. GUASTELLA, Auteur . - p.197-212. Langues : Anglais (eng) in Autism > 30-1 (January 2026) . - p.197-212 Mots-clés : mental health  peer connection  psychological intervention  thematic analysis  treatment Index. décimale : PER Périodiques Résumé : Autistic adults often report high levels of social anxiety and significant life impacts from this anxiety on well-being and functioning. Although cognitive-behavioural therapy in group settings has been adapted for autistic populations, there is a paucity of research exploring how autistic individuals experience CBT interventions. This qualitative study investigated autistic adults’ experiences of a modified cognitive-behavioural therapy group programme for social anxiety. Twenty-seven autistic participants were recruited through clinical services and community outreach. Following the intervention, participants completed semi-structured individual interviews about their experience of the programme. Participants reported both therapeutic benefits and challenges following their participation. Themes included reflections on group dynamics, mental health impacts, social functioning and daily life applications of strategies. Peer connection emerged as a core facilitator of engagement, while structured strategies were credited with bolstering social confidence and self-awareness. However, challenges, such as sensory sensitivities, the role of previous therapeutic experiences and difficulties applying strategies beyond the therapy context, were also highlighted.Lay Abstract Autistic adults often report high levels of social anxiety. To support autistic people with social anxiety, we developed a group therapy programme, the Engage Program, an intervention designed specifically for autistic adults. Our study aimed to better understand what it is like for autistic adults to take part in group therapy and what aspects of the programme were most helpful, or not. The programme aimed to provide a safe space where participants could explore social interactions in a way that felt comfortable and authentic. Rather than encouraging people to hide or ‘camouflage’ their autistic traits, the programme focused on building confidence, self-understanding and meaningful connections with peers. Sessions included guided discussions, structured activities and shared experiences. We interviewed participants who had completed the group programme to hear directly from them about their experiences. Many said they felt less alone and more socially confident after taking part in the group. They appreciated connecting with others who understood their experiences, and they said this helped them feel more accepted and supported. They also reported that participating in the group helped them understand their social strengths and challenges more clearly. However, not everything worked for everyone. Some participants found aspects of the therapy challenging, especially if they had sensory sensitivities or difficult past experiences with therapy. In the future, we want to explore how to make group therapy more flexible and accessible, especially for those who may struggle in traditional settings. This research shows that group therapy can be a powerful way to support autistic adults, especially when it is designed with their needs and preferences in mind. En ligne : https://dx.doi.org/10.1177/13623613251377930 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=578

Exposure, Extinction, and Cognitive Appraisals in Autistic Adults With Social Anxiety: Evidence From a Structured Speech Exposure Task / Bruna B. ROISENBERG in Autism Research, 19-6 (June 2026)  

Public ISBD [article]  inAutism Research > 19-6 (June 2026) . - p.e70268 Titre : Exposure, Extinction, and Cognitive Appraisals in Autistic Adults With Social Anxiety: Evidence From a Structured Speech Exposure Task Type de document : texte imprimé Auteurs : Bruna B. ROISENBERG, Auteur ; Kelsie A. BOULTON, Auteur ; Emma E. THOMAS, Auteur ; Dorothy YU, Auteur ; Adam J. GUASTELLA, Auteur Article en page(s) : p.e70268 Langues : Anglais (eng) Mots-clés : adults  anxiety  depression autistic  psychiatry  social anxiety Index. décimale : PER Périodiques Résumé : ABSTRACT Social anxiety (SA) is highly prevalent among autistic adults, yet little is known about how autistic people respond to common therapeutic strategies, such as exposure tasks. This study examined responses to a structured speech exposure task embedded within an 8-week modified cognitive?behavioral therapy (M-CBT) program. Thirty-two autistic adults with co-occurring SA completed pre- and post-task assessments of anxiety and related cognitive appraisals, including self-focused attention, perceived performance, appearance concerns, and threat appraisals. Participants reported appropriate engagement with the task, characterized by elevated anticipatory anxiety followed by reductions in anxiety during the speech. Responses were largely consistent with CBT models of social anxiety and with reports by those in a social anxiety disorder reference group. Participants overestimated anticipatory anxiety (predicted fear) relative to experienced peak fear during the task. Higher anxiety was associated with greater self-focused attention and stronger threat appraisals, although anxiety correlated positively with self-rated performance. Importantly, the extinction of fear during the speech task was associated with post-treatment response to CBT. Among participants classified as high-extinction, 59% showed clinically significant improvement on the Liebowitz Social Anxiety Scale, Self-Report (LSAS-SR), compared with 25% of those in the low-extinction group. A parallel pattern was observed in a social anxiety disorder comparison group, indicating that the extinction?outcome relationship was similar across autistic and non-autistic adults. This study provides evidence that autistic individuals report fear and anxiety responses in a manner largely consistent with CBT models and that extinction-based processes during exposure are meaningfully associated with treatment response. Further studies employing randomized controlled trials and objective measures of fear are now needed. En ligne : https://doi.org/10.1002/aur.70268 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=589 [article] Exposure, Extinction, and Cognitive Appraisals in Autistic Adults With Social Anxiety: Evidence From a Structured Speech Exposure Task [texte imprimé] / Bruna B. ROISENBERG, Auteur ; Kelsie A. BOULTON, Auteur ; Emma E. THOMAS, Auteur ; Dorothy YU, Auteur ; Adam J. GUASTELLA, Auteur . - p.e70268. Langues : Anglais (eng) in Autism Research > 19-6 (June 2026) . - p.e70268 Mots-clés : adults  anxiety  depression autistic  psychiatry  social anxiety Index. décimale : PER Périodiques Résumé : ABSTRACT Social anxiety (SA) is highly prevalent among autistic adults, yet little is known about how autistic people respond to common therapeutic strategies, such as exposure tasks. This study examined responses to a structured speech exposure task embedded within an 8-week modified cognitive?behavioral therapy (M-CBT) program. Thirty-two autistic adults with co-occurring SA completed pre- and post-task assessments of anxiety and related cognitive appraisals, including self-focused attention, perceived performance, appearance concerns, and threat appraisals. Participants reported appropriate engagement with the task, characterized by elevated anticipatory anxiety followed by reductions in anxiety during the speech. Responses were largely consistent with CBT models of social anxiety and with reports by those in a social anxiety disorder reference group. Participants overestimated anticipatory anxiety (predicted fear) relative to experienced peak fear during the task. Higher anxiety was associated with greater self-focused attention and stronger threat appraisals, although anxiety correlated positively with self-rated performance. Importantly, the extinction of fear during the speech task was associated with post-treatment response to CBT. Among participants classified as high-extinction, 59% showed clinically significant improvement on the Liebowitz Social Anxiety Scale, Self-Report (LSAS-SR), compared with 25% of those in the low-extinction group. A parallel pattern was observed in a social anxiety disorder comparison group, indicating that the extinction?outcome relationship was similar across autistic and non-autistic adults. This study provides evidence that autistic individuals report fear and anxiety responses in a manner largely consistent with CBT models and that extinction-based processes during exposure are meaningfully associated with treatment response. Further studies employing randomized controlled trials and objective measures of fear are now needed. En ligne : https://doi.org/10.1002/aur.70268 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=589

A qualitative evaluation of cognitive-behavioural therapy components for social anxiety in autistic adults: Lived experiences from a modified group program / Bruna B. ROISENBERG in Autism, 30-5 (May 2026)  

Public ISBD [article]  inAutism > 30-5 (May 2026) . - p.1147-1164 Titre : A qualitative evaluation of cognitive-behavioural therapy components for social anxiety in autistic adults: Lived experiences from a modified group program Type de document : texte imprimé Auteurs : Bruna B. ROISENBERG, Auteur ; Kelsie A. BOULTON, Auteur ; Emma E. THOMAS, Auteur ; Nina PERRY, Auteur ; Dorothy YU, Auteur ; Adam J. GUASTELLA, Auteur Article en page(s) : p.1147-1164 Langues : Anglais (eng) Mots-clés : anxiety  group therapy  mental health  psychological intervention  qualitative methodologies  treatment Index. décimale : PER Périodiques Résumé : Cognitive-behaviour therapy (CBT) is an evidence-based treatment for social anxiety. However, despite the high prevalence of social anxiety among autistic adults, much less is known about how autistic people experience each CBT component used in treatment. This qualitative study explores autistic adults’ perspectives on a modified cognitive-behaviour therapy group programme for social anxiety, focusing on the perceived effectiveness of CBT components and the identification of needed modifications. Twenty-seven participants who completed the intervention took part in semi-structured interviews. Thematic analysis identified core themes related to therapeutic impact (application of CBT group strategies) and participant experiences (suggestions for future iterations of social groups). Overall, exposure tasks were viewed as helpful in reducing anxiety, particularly when structured and predictable. Cognitive restructuring was often experienced as effective; however, its impact was sometimes limited by persistent and deeply held core beliefs and past negative experiences. Social strategies and anxiety management skills were appreciated for their structured format and educational elements, but generalizability was sometimes raised as a limitation. Participants also recommended additional adaptations, including flexibility in content delivery and modifications to the physical environment. Findings highlight overall support of cognitive-therapy components for reducing social anxiety in adults, but also benefit to tailoring CBT approaches to theneeds of autistic adults. Results from this study offer practical guidance from autistic people to enhance the acceptability and effectiveness of future CBT interventions.Lay abstract Many autistic adults experience social anxiety, making everyday interactions feel stressful or overwhelming. To help with this, clinical researchers developed a group therapy programme based on cognitive-behaviour therapy adapted for autistic adults. While cognitive-behaviour therapy is commonly used to treat anxiety, there has been relatively little research into how autistic people experience group-based versions of this therapy. This study aimed to understand how participants felt about the programme and how it could be improved. The intervention included eight group sessions where participants learned about social anxiety and autism, social strategies and took part in guided activities to build confidence. The programme encouraged a supportive environment where autistic individuals could safely try out new ways of connecting with others without feeling pressure to hide who they are. To understand how helpful the programme was, researchers interviewed participants about their experiences. Many said the programme helped them feel more confident and less anxious in social situations. For example, they found role-playing in a safe group setting especially useful. Participants also appreciated that the therapy was adapted to suit their needs. However, the study also highlighted some areas for improvement. Some participants found parts of the programme challenging, especially unstructured activities or settings. Others suggested the programme could be more flexible, offer clearer instructions or be better prepared for people who had past negative experiences with therapy. These early findings suggest that cognitive-behaviour therapy can be effective when thoughtfully adapted for autistic adults. This work helps lay the foundation for more inclusive, autism-informed mental health services that support social confidence in a way that feels safe and empowering. En ligne : https://dx.doi.org/10.1177/13623613261424830 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=585 [article] A qualitative evaluation of cognitive-behavioural therapy components for social anxiety in autistic adults: Lived experiences from a modified group program [texte imprimé] / Bruna B. ROISENBERG, Auteur ; Kelsie A. BOULTON, Auteur ; Emma E. THOMAS, Auteur ; Nina PERRY, Auteur ; Dorothy YU, Auteur ; Adam J. GUASTELLA, Auteur . - p.1147-1164. Langues : Anglais (eng) in Autism > 30-5 (May 2026) . - p.1147-1164 Mots-clés : anxiety  group therapy  mental health  psychological intervention  qualitative methodologies  treatment Index. décimale : PER Périodiques Résumé : Cognitive-behaviour therapy (CBT) is an evidence-based treatment for social anxiety. However, despite the high prevalence of social anxiety among autistic adults, much less is known about how autistic people experience each CBT component used in treatment. This qualitative study explores autistic adults’ perspectives on a modified cognitive-behaviour therapy group programme for social anxiety, focusing on the perceived effectiveness of CBT components and the identification of needed modifications. Twenty-seven participants who completed the intervention took part in semi-structured interviews. Thematic analysis identified core themes related to therapeutic impact (application of CBT group strategies) and participant experiences (suggestions for future iterations of social groups). Overall, exposure tasks were viewed as helpful in reducing anxiety, particularly when structured and predictable. Cognitive restructuring was often experienced as effective; however, its impact was sometimes limited by persistent and deeply held core beliefs and past negative experiences. Social strategies and anxiety management skills were appreciated for their structured format and educational elements, but generalizability was sometimes raised as a limitation. Participants also recommended additional adaptations, including flexibility in content delivery and modifications to the physical environment. Findings highlight overall support of cognitive-therapy components for reducing social anxiety in adults, but also benefit to tailoring CBT approaches to theneeds of autistic adults. Results from this study offer practical guidance from autistic people to enhance the acceptability and effectiveness of future CBT interventions.Lay abstract Many autistic adults experience social anxiety, making everyday interactions feel stressful or overwhelming. To help with this, clinical researchers developed a group therapy programme based on cognitive-behaviour therapy adapted for autistic adults. While cognitive-behaviour therapy is commonly used to treat anxiety, there has been relatively little research into how autistic people experience group-based versions of this therapy. This study aimed to understand how participants felt about the programme and how it could be improved. The intervention included eight group sessions where participants learned about social anxiety and autism, social strategies and took part in guided activities to build confidence. The programme encouraged a supportive environment where autistic individuals could safely try out new ways of connecting with others without feeling pressure to hide who they are. To understand how helpful the programme was, researchers interviewed participants about their experiences. Many said the programme helped them feel more confident and less anxious in social situations. For example, they found role-playing in a safe group setting especially useful. Participants also appreciated that the therapy was adapted to suit their needs. However, the study also highlighted some areas for improvement. Some participants found parts of the programme challenging, especially unstructured activities or settings. Others suggested the programme could be more flexible, offer clearer instructions or be better prepared for people who had past negative experiences with therapy. These early findings suggest that cognitive-behaviour therapy can be effective when thoughtfully adapted for autistic adults. This work helps lay the foundation for more inclusive, autism-informed mental health services that support social confidence in a way that feels safe and empowering. En ligne : https://dx.doi.org/10.1177/13623613261424830 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=585

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