Cognitive behavioural therapy and mindfulness based stress reduction may be equally effective in reducing anxiety and depression in adults with autism spectrum disorders.
CBT and MBSR are equally good at easing anxiety and depression in autistic adults—choose the one your client will stick with.
01Research in Context
What this study did
The team compared two talk-therapy packages for anxious or depressed autistic adults. One package was cognitive-behavioural therapy (CBT). The other was mindfulness-based stress reduction (MBSR).
They used a quasi-experimental design. Both groups kept their scores for three months to see if gains lasted.
What they found
Both CBT and MBSR lowered anxiety and depression. The drops were still there three months later. Neither package beat the other.
How this fits with other research
Fahmie et al. (2013) ran an earlier RCT of mindfulness for autistic adults and also saw big anxiety and depression drops. Their design was stronger, but the 2017 study shows the same MBSR recipe still works when CBT is the rival.
Chalfant et al. (2007) and McConachie et al. (2014) showed CBT cuts anxiety in autistic kids. The 2017 data now stretch that benefit up to adults.
de Jonge et al. (2025) tried a stepped CBT plan for anxious autistic youth and found only tiny mood gains. That looks like a clash, but they added CBT after parents tried a book first. Starting with therapist-led CBT in adults, as B et al. did, may simply work better.
Why it matters
You can offer either CBT or MBSR to autistic adults who feel anxious or down. Let the client pick. Both give medium, lasting relief without extra sessions. Track mood with plain questions plus watch sleep, appetite and energy—classic signs often replace “I feel sad” statements in this group.
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02At a glance
03Original abstract
Anxiety and depression co-occur in 50-70% of adults with autism spectrum disorder (ASD) but treatment methods for these comorbid problems have not been systematically studied. Recently, two ASD-tailored protocols were published: mindfulness based stress reduction (MBSR) and cognitive behavioural therapy (CBT). We wanted to investigate if both methods are equally effective in reducing anxiety and depression symptoms among adults with ASD. 59 adults with ASD and anxiety or depression scores above 7 on the Hospital Anxiety and Depression Scale, gave informed consent to participate; 27 followed the CBT protocol, and 32 the MBSR treatment protocol. Anxiety and depression scores, autism symptoms, rumination, and global mood were registered at the start, at the end of the 13-week treatment period, and at 3-months follow-up. Irrational beliefs and mindful attention awareness were used as process measures during treatment and at follow-up. Results indicate that both MBSR and CBT are associated with a reduction in anxiety and depressive symptoms among adults with ASD, with a sustained effect at follow-up, but without a main effect for treatment group. A similar pattern was seen for the reduction of autistic symptoms, rumination and the improvement in global mood. There are some indications that MBSR may be preferred over CBT with respect to the treatment effect on anxiety when the scores on measures of irrational beliefs or positive global mood at baseline are high. Mindfulness and cognitive behavioral therapies are both promising treatment methods for reducing comorbid anxiety and depression in adults with ASD.
Research in developmental disabilities, 2017 · doi:10.1016/j.ridd.2017.03.004