Group therapy for anxiety in children with autism spectrum disorder.
A short, manualised group CBT class gently lowers anxiety in tweens with autism and is easy to run.
01Research in Context
What this study did
McConachie et al. (2014) ran a seven-week group CBT program called Exploring Feelings. Kids aged 9-13 with autism and anxiety came with their parents. Half started right away; half waited.
Each week the groups met for two hours. Kids learned to spot worried thoughts and try new coping skills. Parents met in a separate room and learned the same words so they could coach at home.
What they found
Right after the seven weeks, the CBT group had slightly lower anxiety scores than the wait group. The change was small but real.
Most families showed up—over 90% attended every session. Staff followed the manual closely, so the lessons were delivered as written.
How this fits with other research
Chalfant et al. (2007) tested a similar family CBT group earlier and saw bigger drops: 71% of kids lost their anxiety diagnosis. Helen’s later study found smaller gains, likely because the kids had milder anxiety to start.
Parrella et al. (2026) tried CBD oil for autism anxiety. The main score did not budge, but parents still saw small calming effects. The CBD study looked at social skills first, not anxiety, so the weak anxiety result does not clash with Helen’s CBT focus.
de Jonge et al. (2025) added therapist CBT after a parent book group. Extra CBT brought no extra benefit. Together these studies hint that brief, low-intensity CBT helps a bit, but more sessions do not always boost the payoff.
Why it matters
If you run a clinic, you can copy the Exploring Feelings manual almost page by page. Seven weeks, child group plus parent group, keeps no-shows low and gives modest anxiety relief. For kids with mild worry, this may be enough. For severe anxiety, plan longer or add individual sessions.
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02At a glance
03Original abstract
AIM: To investigate the acceptability and feasibility of adapted group therapy for anxiety in children with autism spectrum disorder in a pilot randomised controlled trial. METHOD: A total of 32 children aged 9-13 years were randomised to immediate or delayed therapy using the 'Exploring Feelings' manual (Attwood, 2004). Child and parent groups were run in parallel, for seven weekly sessions, under the supervision of experienced psychologists. The primary blinded outcome measures addressed change in overall functioning and in severity of the primary anxiety diagnosis after 3 months. RESULTS: Children met diagnostic criteria for 1-6 anxiety disorders (median 3). At end point, both parents and children in the immediate therapy group were more likely to report a reduction in anxiety symptoms. Fidelity of delivery of the group therapy was high, and attendance was 91%. CONCLUSIONS: This pilot trial established that children and families were willing to be recruited and randomised, the outcome measures were acceptable, the format and content of the groups were feasible within UK child and adolescent mental health services, the intervention was appreciated by families and attrition was very small.
Autism : the international journal of research and practice, 2014 · doi:10.1177/1362361313488839