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Exploring the concurrent use of standardised and idiographic measures to assess cognitive behavioural therapy in a university student with autistic spectrum condition – a single case experimental design

Published online by Cambridge University Press:  28 June 2021

Nicola Birdsey Open the ORCID record for Nicola Birdsey [Opens in a new window]  and
Linda Walz
Nicola Birdsey*
Affiliation:
Department of Psychology, University of Bath, Bath, UK
Linda Walz
Affiliation:
Avon and Wiltshire Mental Health Partnership NHS Trust, UK
*
*Corresponding author. Email: [email protected]
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Abstract

Limited research has directly addressed the challenges of higher education for students with autism, who face additional difficulties in navigating social, personal and academic obstacles. With more students experiencing mental health difficulties whilst at university, therapeutic interventions on offer need to be suitable for those accessing support. Cognitive behavioural therapy (CBT) is widely used to support university students, as it is firmly established as an effective treatment for a range of issues, including social and generalised anxiety in typically developing populations (NICE, 2013; NICE, 2019). However, the efficacy of CBT for individuals with autistic spectrum condition (ASC) is less well known, despite the high prevalence rates of anxiety in this population. This paper seeks to address a gap in the literature and uses a single-case (A-B) experimental design over 16 sessions to reduce co-morbid social and generalised anxiety in a university student with high-functioning ASC. Clark’s (2001) cognitive model of social anxiety and Wells’ (1997) cognitive model of generalised anxiety were employed to formulate anxiety experienced in this case. Standardised outcome measures were used for social anxiety, i.e. the Social Phobia Inventory (SPIN), and generalised anxiety, i.e. the Generalised Anxiety Disorder-7 (GAD-7), in conjunction with idiographic ratings to assess the impact of therapy. Findings indicate that CBT was an acceptable and useful intervention with mixed results; discrepancies were found between clinical change recorded on standardised measures compared with idiographic ratings. This paper discusses the use of standardised measures of anxiety for individuals with ASC and identifies directions for further research.

Key learning aims

  1. (1) To appreciate the unique mental health challenges of university students with ASC.

  2. (2) To identify psychological interventions that are suitable for individuals with ASC.

  3. (3) To consider the value in employing more than one evidence-based cognitive model of anxiety when clients present with co-morbid mental health issues.

  4. (4) To question the utility of using standardised outcome measures compared with idiographic measures in therapy.

Keywords

ASCCBTco-morbidgeneralised anxietyhigher educationsocial anxiety
Type
Case Study
Information
the Cognitive Behaviour Therapist , Volume 14 , 2021 , e18
Copyright
© The Author(s), 2021. Published by Cambridge University Press on behalf of the British Association for Behavioural and Cognitive Psychotherapies

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References

Further reading

Davis, T. E., White, S. W. and Ollendick, T. (eds) (2014). Handbook of Autism and Anxiety. New York, USA: Springer.10.1007/978-3-319-06796-4CrossRefGoogle Scholar
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National Institute for Health and Care Excellence (2012). Autism: recognition, referral, diagnosis and management of adults on the autism spectrum, NICE Clinical Guideline 142. London, UK: British Psychological Society & The Royal College of Psychiatrists.Google Scholar

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