New Publication! The Facing Your Fears Program

New Publication! Facing Your Fears Effective at Reducing Anxiety and Depression Symptoms in Autistic Youth

Youth on the Autism spectrum often experience psychiatric complexity, with one of these complexities being depression. Autistic youth are almost 4 times more likely to experience depression, with at least 70% of autistic youth experiencing one mental health concern. A specific type of cognitive behavioural therapy (CBT) called Facing Your Fears, is adapted to autistic youth ages 8-14 and is shown to be effective at improving anxiety in autistic youth with low support needs. However, limited research has investigated if Facing Your Fears could also improve symptoms of other mental health symptoms, such as depression, and how other co-occurring mental health conditions may impact youth’s responses to this treatment.  In a novel study, the team at BC Children’s Hospital and the ENHANCE Lab investigated just this and are one of the first to investigate the impact of Facing Your Fears on conditions other than anxiety.  

What is Facing Your Fears?  

Facing your Fears is an adapted cognitive-behavioural intervention designed for youth (aged 8-14 years) with low support needs who have a co-occurrence of Autism and anxiety. This 14-week CBT program includes group sessions, caregiver-child sessions, and separate child-only and caregiver-only sessions.  

The program focuses on increasing awareness and learning to identify emotions like anxiety, and potential triggers or situations that can cause these emotions. Youth then learn ways to face their fears using specific skills along with help from clinicians and caregivers. Caregivers will also learn the caregiving approaches that can positively or negatively impact their child’s anxiety, and how to support their child when they are worried or facing their fears through specific strategies. The intervention is primarily designed to help reduce anxiety in this population, however, the current study looked at two added complexities.  

1) Does the FYF intervention also impact outcomes outside of anxiety, specifically depression?  

2) Does psychiatric complexity, meaning having more diagnoses, such as ADHD or multiple anxiety disorders - impact the effectiveness of FYF? 

What Did the Study Do? 

Fifty-one Autistic youth, ages 8 to 14 years, and their caregiver participated in the Facing Your Fears program. Autistic youth had varying psychiatric complexity assessed before and after the intervention.  

Youth were grouped according to psychiatric complexity - autistic youth with just anxiety, autistic youth with anxiety and ADHD, and autistic youth with anxiety and other co-occurring conditions. For each group, levels of anxiety and depression were measured and compared before and after the intervention to determine if co-occurring conditions impact the effectiveness of FYF in treating these mental health conditions. 

What Did the Study Find? 

In collaboration with BC Children’s Hospital, we found that across all participants, there was a reduction in anxiety symptoms and depression symptoms. This was found regardless of psychiatric complexity

. 

Why is this Important? 

This study is one of the first to look at the secondary effect of FYF outside of anxiety reduction, highlighting the reduction of depressive symptoms. This calls attention to the need to understand treatments, supports, and interventions beyond a primary diagnosis – to understand that its effects are transdiagnostic. Also, the study brings attention to the need to understand co-occurrence and psychiatric complexities, especially as in populations such as Autistic youth, it's experienced by such many individuals. In this case, the intervention effectively worked across differing co-occurrences; however, that may not always be the case and should be considered in future research.  

Where can I read the whole research publication?

If you are interested in learning more about the study and findings, check out the full publication here: https://authors.elsevier.com/sd/article/S1750-9467(24)00138-7

Interested in participating in FYF? 

If your child experiences a co-occurrence of autism and anxiety, you may be eligible to participate in the 14-week FYF intervention. If you and your child are interested in participating in FYF please contact enhancelab@ucalgary.ca