Virtual delivery of group-based cognitive behavioral therapy for autistic children and youth during the COVID-19 pandemic was acceptable, feasible, and effective

Anxiety challenges co-occur at a high rate in autistic children and youth (~ 50-79%), often with significant interference with daily functioning. Evidence-based interventions (e.g., cognitive behavioral therapy (CBT)-based approaches) are effective in treating anxiety disorders across populations. Facing your fears (FYF), a group-based CBT program modified for youth with ASD, yields positive outcomes in controlled research settings and community implementation, but access is constrained by limited system capacity and families' distance from specialized centers. COVID-19 spurred innovations in virtual delivery of care, generating possibilities for increased scalability of evidence-based treatments. This study investigated the feasibility, acceptability, and effectiveness of FYF when delivered virtually through a tertiary care hospital in Ontario. Data were collected over one year (N = 100 autistic children/youth aged 8-13 years and their caregivers). Significant improvements emerged in caregiver- and self-reported anxiety symptoms, and caregivers reported increased self-efficacy in supporting their child with their anxiety. Significant predictors of treatment response included youth baseline anxiety, level of adaptive functioning, ASD symptoms, and caregiver self-efficacy. Three COVID-related factors were small but significant contributors to the model. Virtual delivery of FYF is feasible and effective for treating elevated anxiety in autistic children/youth and may improve access.ClinicalTrials.gov identifier: NCT04666493.