Cognitive Behavior Therapy (CBT) & Autism Spectrum - MGH Clay Center

CBT Snapshot: Using Cognitive Behavior Therapy for Asperger’s, High-Functioning Autism, and Pervasive Developmental Disorder (PDD)

Teenage girl sitting on a couch talking to a therapist

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Posted in: Parenting Concerns

Topics: Autism Spectrum, Mental Illness + Psychiatric Disorders

Cognitive Behavioral Therapy is a special kind of talk therapy that can be used to help with mental health challenges, including those related to Autism Spectrum Disorder. In this CBT Snapshot series, Dr. Ellen Braaten gives a glimpse of what it looks like to use CBT for a range of mental, behavioral, and developmental health disorders.

Because Cognitive Behavior Therapy (CBT) helps children focus on why they behaved the way they did and the consequences of their behavior, CBT can be very useful for children and adolescents who have difficulty reading and interpreting social cues. CBT can be effective for children with Asperger’s/Pervasive Developmental Disorder (PDD) who are treated in either group or individual formats. This therapy particularly helps children link emotions, responses, and consequences – links that are very difficult for children on this spectrum to make. Because this is difficult, this type of therapy is most useful in children who can cognitively make these links, so it’s most effective for adolescents and young adults who have mature abstract reasoning skills.

For example:

Claire, a 16-year-old with Asperger’s, came to her therapy appointment quite confused because of the difficult week she had experienced. A few days prior, she had written “Jenna sucks” and “Jenna should die” on the school’s bathroom wall. Once it was discovered that she wrote this, she was suspended until she received a thorough psychological evaluation. The evaluation indicated that she was not dangerous, but that she did not realize the implications of her actions. Claire was angry at Jenna (a friend) because Jenna had befriended a classmate, and Claire thought Jenna didn’t like her anymore.

Claire’s therapist helped her to understand the links between her emotions, behavior, and consequences. Claire was able (with some effort) to articulate her anger at Jenna, and was also able to see how her anger may have been an overreaction to a situation that she had misinterpreted. Claire didn’t realize that writing aggressive statements on bathroom walls could get her in trouble. She also had limited awareness of other outcomes of her behaviors. For example, Claire didn’t realize that other kids might be less likely to associate with her because she had been suspended from school. Therapy also helped Claire learn better ways to manage these feelings in the future.

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Ellen Braaten, PhD

Ellen Braaten, PhD

Ellen Braaten, PhD, is executive director of the Learning and Emotional Assessment Program (LEAP) at  Massachusetts General Hospital (MGH), an associate professor of psychology at Harvard Medical School, and former co-director for the MGH Clay Cente...

To read full bio click here.