Anxiety disorders affect up to 50% of individuals with autism spectrum disorder (ASD) and are significantly impairing to the person affected, as well as to their loved ones. Cognitive-behavioral therapy (CBT) has been established as the gold-standard treatment for anxiety disorders among typically developing youth and adults, and demonstrates similar efficacy among youth with high-functioning autism (HFA). Many CBT interventions utilize a “full-package” treatment approach to treat co-occurring anxiety in youth with ASD. However, these service delivery systems are often therapist-intensive, costly, and impractical, thereby compromising full engagement and treatment adherence. This paper describes the design, rationale, and methodology of a study examining stepped-care CBT for youth with HFA and co-occurring anxiety – a clinical trial examining the efficacy of low-intensity, parent-led CBT as the first line of treatment and utilizing a more intensive, therapist-led intervention for nonresponders. The study will evaluate the potential benefits of stepped-care and parent-led therapist-assisted interventions, predictors of treatment response, and the economic value of using a stepped-care model. Implications for practice will be discussed.

中文翻译：

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针对自闭症和共存焦虑症青少年的家长主导、阶梯式护理认知行为疗法：研究原理和方法

焦虑症影响多达 50% 的自闭症谱系障碍 (ASD) 患者，并且对受影响的人以及他们的亲人造成严重损害。认知行为疗法 (CBT) 已被确立为典型发展青年和成人焦虑症的金标准治疗方法，并在患有高功能自闭症 (HFA) 的青年中表现出相似的疗效。许多 CBT 干预措施采用“一揽子”治疗方法来治疗患有 ASD 的青少年同时发生的焦虑。然而，这些服务提供系统通常是治疗师密集、昂贵且不切实际的，从而影响了充分参与和治疗依从性。本文描述了设计、原理、一项研究对患有 HFA 和同时发生的焦虑症的青少年进行阶梯式护理 CBT 的研究的方法和方法——一项临床试验，检查低强度、父母主导的 CBT 作为第一线治疗的疗效，并利用更密集的、治疗师主导的对无反应者的干预。该研究将评估阶梯式护理和家长主导的治疗师辅助干预措施的潜在益处、治疗反应的预测因素以及使用阶梯式护理模型的经济价值。将讨论对实践的影响。以及使用阶梯式护理模式的经济价值。将讨论对实践的影响。以及使用阶梯式护理模式的经济价值。将讨论对实践的影响。