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Clinical Trial
. 2025 Feb 27;15(1):7034.
doi: 10.1038/s41598-025-88779-7.

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

Jessica Brian  1 , Abbie Solish  2 , Jonathan Leef  2 , Jenny Nguyen  2 , Laura Bickle  3 , Robyn Budovitch  4 , Victoria Chan  2 , Brianne Drouillard  2 , Ellen Drumm  5 , Lisa Genore  2 , Rianne Hastie Adams  2 , Robin Hermolin  2 , Nora Klemencic  4 , Maude Lambert  6 , Kristina Lee  7 , Janys Lim  8 , Kathleen Mak-Fan  3 , Monica O'Neill  2 , Stephanie Price  9 , Melissa Pye  10 , Elizabeth Selezneva  2 , Azin Taheri  2 , Evdokia Anagnostou  2
Affiliations
Clinical Trial

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

Jessica Brian et al. Sci Rep. .

Abstract

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.

Keywords: Anxiety; Autism; Autism spectrum disorder; COVID-19; Caregiver; Cognitive behavioral therapy; Community; Group; Implementation; Intervention; Mental health; Virtual care.

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Conflict of interest statement

Declarations. Competing interests: EA reports the following potential conflicts: Grants from industry (Roche, SynpDx, Maplight, Anavex; Sanofi Aventis), consultations (ROChe, Ono, Impel, Cell-EI, Quadrant) and in-kind supports (AMO pharma, CRA), editorial honoraria/ book royalties (Wiley, APPI, Springer), and a patent (Anxiety Meter). All other authors declare that the research was conducted in the absence of any commercial or financial relationships that could be perceived as a potential or actual conflicts of interest. Ethics statement: This study involving human participants was approved by the Research Ethics Board at Holland Bloorview Kids Rehabilitation Hospital. The study was conducted in accordance with local legislation and institutional requirements. Participants provided written informed consent as described in the manuscript.

Figures

Fig. 1
Fig. 1
CONSORT diagram of study flow.
Fig. 2
Fig. 2
Local health integration network regions represented by study participants.
See this image and copyright information in PMC

References

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