Interventions for adults with autism spectrum disorders who experience anxiety

A snapshot of research for adults and health professionals

The purpose of this resource is to provide a brief overview of interventions that aim to help adults with ASD to address anxiety. We aim to equip adults with ASD and the health professionals who support them with information that helps them to better understand the literature related to anxiety and adults with ASD.

This resource was developed through Ms Cindy Nicollet’s PhD research, which is part of the Autism CRC project called Tools, strategies and techniques developed to improve the health and wellbeing for adults with ASD. This project aims to enhance health and wellbeing in adults with ASD and their families.

Anxiety & adults with ASD

Anxiety can affect any person, including a person with ASD. Experiencing anxiety can be challenging, because it can make employment, education and socialising difficult. For a person with ASD, anxiety can impact social relationships and increase repetitive, idiosyncratic behaviours and routines. It is important to find appropriate interventions to assist individuals with ASD and anxiety, particularly for adults who want to work, study or be social. But, we know very little about ‘what works’ to help adults with ASD with their anxiety.

What we did

We searched online databases using specific keywords to find studies that examined the effectiveness of interventions to reduce anxiety among adults with ASD. Since there is very little work that focusses on adults, we also looked for interventions for adolescents aged 13 years or older. We read all the relevant papers and assessed the quality of the studies they presented.

What we found

We found 13 papers that described interventions aiming to reduce anxiety among adolescents and adults with ASD. The table below describes each of the 13 papers. We ranked the papers using Downs and Black Checklist for Quality Assessment of non-RCTs, with a higher score (out of 28) suggesting the paper met more of the items on the checklist. A higher score doesn’t necessarily equate to a ‘better’ paper; instead it means that the study described was conducted in a way that meets scientific criteria for validity: it’s one way to assess whether the study findings can be applied to other groups and contexts.

Next steps

As part of her PhD, Ms Nicollet will use the literature presented here, as well as discussions with adults with ASD and mental health professionals, to develop an online anxiety intervention for adults with ASD.
For more information about this project, please contact Ms Nicollet at


You can find these papers online. Those marked with a (*) are available for free to download by clicking on the title and following the URL.

Cardaciotto, L., & Herbert, J. D. (2004). Cognitive Behavior Therapy for Social Anxiety Disorder in the Context of Asperger's Syndrome: A Single-Subject Report. Cognitive and Behavioral Practice, 11, 75-81.


Freitag, C. M., Cholemkery, H., Elsuni, L., Kroeger, A. K., Bender, S., Kunz, C. U., & Kieser, M. (2013). The group-based social skills training SOSTA-FRA in children and adolescents with high functioning autism spectrum disorder--study protocol of the randomised, multi-centre controlled SOSTA--net trial. Trials, 14(6), 12. doi: 10.1186/1745-6215-14-6


Kiep, M., Spek, A. A., & Hoeben, L. (2014). Mindfulness-based therapy in adults with an autism spectrum disorder: Do treatment effects last? Mindfulness, 8. doi: 10.1007/s12671-014-0299-x


Langdon, P. E., Murphy, G. H., Wilson, E., Shepstone, L., Fowler, D., Heavens, D., . . . Russell, A. (2013). Asperger syndrome and anxiety disorders (PAsSA) treatment trial: A study protocol of a pilot, multicentre, single-blind, randomised crossover trial of group cognitive behavioural therapy. British Medical Journal Open, 3(7), 6. doi: 10.1136/bmjopen-2013-003449


McGillivray, J. A., & Evert, H. T. (2014). Group Cognitive Behavioural Therapy Program Shows Potential in Reducing Symptoms of Depression and Stress Among Young People with ASD. Journal of Autism & Developmental Disorders, 11. doi: 10.1007/s10803-014-2087-9


Ozsivadjian, A., & Knott, F. (2011). Anxiety problems in young people with autism spectrum disorder: a case series. Clin Child Psychol Psychiatry, 16(2), 203-214. doi: 10.1177/1359104511404749


Reaven, J., Blakeley-Smith, A., Leuthe, E., Moody, E., & Hepburn, S. (2012). Facing your fears in adolescence: cognitive-behavioral therapy for high-functioning autism spectrum disorders and anxiety. Autism Res Treat, 2012, 13. doi: 10.1155/2012/423905


Russell, A. J., Jassi, A., Fullana, M. A., Mack, H., Johnston, K., Heyman, I., Mataix‐Cols, D. (2013). Cognitive behavior therapy for comorbid obsessive-compulsive disorder in high-functioning autism spectrum disorders: A randomized controlled trial. Depress Anxiety, 30(8), 697-708.


Spek, A. A., Ham, N. C., & Nyklícek, I. (2013). Mindfulness-based therapy in adults with an autism spectrum disorder: a randomized controlled trial. Res Dev Disabil, 34(1), 246-253. doi: 10.1016/j.ridd.2012.08.009


Weiss, J. A., & Lunsky, Y. (2010). Group cognitive behaviour therapy for adults with Asperger syndrome and anxiety or mood disorder: a case series. Clinical Psychology and Psychotherapy, 17(5), 438-446. doi: 10.1002/cpp.694


White, S., Ollendick, T., Albano, A., Oswald, D., Johnson, C., Southam-Gerow, M., Scahill, L. (2013). Randomized Controlled Trial: Multimodal Anxiety and Social Skill Intervention for Adolescents with Autism Spectrum Disorder. Journal of Autism & Developmental Disorders, 43(2), 382-394. doi: 10.1007/s10803-012-1577-x


White, S. W., Ollendick, T., Scahill, L., Oswald, D., & Albano, A. M. (2009). Preliminary efficacy of a cognitive-behavioral treatment program for anxious youth with autism spectrum disorders. J Autism Dev Disord, 39(12), 1652-1662. doi: 10.1007/s10803-009-0801-9


Wright, K. P. (2013). Cognitive behavioural therapy for anxiety in a man with autism spectrum disorder, intellectual disability, and social phobia. Advances in Mental Health and Intellectual Disabilities, 7(5), 284-292. doi: 10.1108/AMHID-06-2013-0040