Adaptations to cognitive behavioural therapy for autistic children and young people with anxiety: A systematic review

Children and young people with autism have an increased risk of developing anxiety disorders. While the effectiveness of cognitive behavioural therapy (CBT) for anxiety in autistic youths is well researched, less is known about the active ingredients to adapting therapy. This review (PROSPERO: CRD42023429990) summarises the modifications for CBT for anxiety in autistic youths. Systematic searches across five databases led to the identification of 31 eligible studies. A narrative synthesis highlighted the importance of practical modifications, parent and teacher input, affective education, skills training, feedback, and practice of CBT tasks. Future research should examine the effectiveness of these different adaptations across different ages and minoritised groups. • Synthesises modifications in 31 studies examining modified CBT for children and young people with anxiety. • Practical adjustments, affective education, skills training and parent/teacher feedback are frequent adaptations to CBT. • Findings can inform future effectiveness research and therapy delivery guidelines for this population.