Children and adults with autism spectrum disorders (ASD) can benefit from cognitive behaviour therapy (CBT), yet the prevailing opinion is that this requires adaptations to accommodate commonly experienced socio-communication and neuropsychological impairments. There are, however, no empirically-derived guidelines about how best to adapt standard practice. In a three round Delphi survey, we asked expert clinicians and clinical-researchers, based in England, about how to optimise the design, delivery and evaluation of CBT for people with ASD. Of 50 people approached, 18 consented to take part in Round 1, nine in Round 2 and eight in Round 3. Using a five-point scale, participants rated the degree to which 221 statements—pertaining to the referral process, assessment, engagement, formulation, goal setting, therapy structure, interventions and techniques, homework, outcome measurement, managing endings and therapist attributes—were integral to CBT. The consensus was that 155 statements represented essential or important components of CBT. Adaptations to the structure and process of therapy were consistently endorsed, and an individualised formulation-derived approach was favoured when deciding upon which interventions and techniques to offer. Further studies are needed to clarify if adapted CBT is associated with improved treatment outcomes and acceptability.

中文翻译：

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如何优化自闭症谱系障碍 (ASD) 患者的认知行为疗法 (CBT)：德尔福研究

患有自闭症谱系障碍 (ASD) 的儿童和成人可以从认知行为疗法 (CBT) 中受益，但普遍的观点是，这需要进行调整以适应常见的社会交流和神经心理障碍。然而，没有关于如何最好地适应标准实践的经验派生指南。在德尔福 (Delphi) 的三轮调查中，我们询问了英国的专家临床医生和临床研究人员，了解如何针对 ASD 患者优化 CBT 的设计、实施和评估。在接触的 50 人中，18 人同意参加第 1 轮，第 2 轮 9 人，第 3 轮 8 人。 参与者使用 5 分制对 221 项陈述的程度进行评分——与推荐过程、评估、参与、制定、目标设定、治疗结构、干预和技术、家庭作业、结果测量、管理结局和治疗师属性——是 CBT 不可或缺的一部分。共识是 155 条陈述代表了 CBT 的基本或重要组成部分。对治疗结构和过程的适应性得到一致认可，在决定提供哪些干预措施和技术时，倾向于采用个性化的配方衍生方法。需要进一步的研究来阐明适应的 CBT 是否与改善的治疗结果和可接受性有关。在决定提供哪些干预措施和技术时，倾向于采用个性化的配方衍生方法。需要进一步的研究来阐明适应的 CBT 是否与改善的治疗结果和可接受性有关。在决定提供哪些干预措施和技术时，倾向于采用个性化的配方衍生方法。需要进一步的研究来阐明适应的 CBT 是否与改善的治疗结果和可接受性有关。