A Change in Thinking
By Emma Loveall
Throughout the day I find myself thinking negative thoughts: “I don’t think they like me”, “Why did I say that”, or “I wish I could do that.” If you’re like me, defeatist thoughts are almost more common than positive ones. Little did I know the power of these thoughts. The way we talk to ourselves essentially shapes the way we see the world. Each of us see things from our own unique perspectives. We have distinct mental processes and responses, but what if you were able to change the way you thought about everything? Some individuals are altering their inner dialogue to better respond to any and all situations. As humans, we are “meaning makers.” We take in what is happening and give it meaning, filled with emotion. Then we behave. Unfortunately, some people get stuck in negative patterns of thinking and feeling. It is often a result of a skewed meaning-making system. This is especially common in individuals with autism spectrum disorder (ASD). ASD is a group of developmental disorders that can cause significant social and behavioral challenges. Those with ASD are at greater risk for experiencing symptoms of anxiety. Here enters cognitive behavioral therapy (CBT). CBT attempts to eliminate these distorted thoughts. It helps people shift the way they interpret a situation, their feelings throughout the situation, and how they respond.
CBT is based on several core principles, including:
Psychological problems are based on faulty or unhelpful ways of thinking.
Psychological problems are based on learned patterns of unhelpful behavior.
People suffering from psychological problems can learn better ways of coping with them, in turn relieving their symptoms and becoming more effective in their lives.
CBT is used as a treatment for a variety of disorders such as depression, alcohol and drug use problems, marital problems, eating disorders, and anxiety disorders. Today, anxiety disorders are the most common mental disorders. This was not particularly surprising to me. Millions are suffering from anxiety related disorders and their prevalence continues to increase. As briefly mentioned above, one of the most affected groups is individuals on the autism spectrum (“Anxiety,” 2021). In recent years, there have been several attempts to adapt CBT for children and teens with ASD. Recent evidence has found that cognitive behavioral therapy can greatly impact the way they think, feel, and behave. CBT is made up of two main parts: the cognitive component helps children change how they think about a situation, whereas the behavioral component helps children change how they react to a situation. Before this therapy could be utilized in children on the autism spectrum, it needed to be determined whether or not they have the necessary tools to succeed at CBT. Children with ASD had their cognitive skills evaluated and the results were compared with peers (Anderson, 2012). The findings showed that nearly all autistic children were capable of distinguishing thoughts, feelings, and behaviors. These are the necessary components for them to work on altering their own thoughts. Let's discuss what cognitive behavioral therapy looks like. During CBT sessions a child will meet with a trained therapist and learn how their thoughts, feelings, and behaviors impact others. The therapist teaches strategies to adjust unwanted feelings and problematic behavior. CBT treatment typically involves efforts to change thinking patterns. These strategies might include recognizing one’s thinking patterns that are creating problems and then reevaluating them in real-world contexts. Next, it helps the child to better understand others' motivations. One of the largest goals is to develop confidence. The treatment also takes measures to change behavioral patterns such as facing one’s fears, using role-playing to prepare for problematic interactions, and learning to calm one’s mind to relax the body.
Perihan et al., 2019 looked at collection of studies in hopes of answering these three questions:
To what extent can CBT reduce anxiety-related outcomes in children with ASD?
Does parent involvement in CBT impact anxiety levels in children with ASD?
Does treatment length impact the overall effects of CBT in children with ASD?
After looking at the research, Perihan and his colleagues were able to answer all three questions. First, they determined that cognitive behavioral therapy did in fact reduce anxiety symptoms. Secondly, parent-assisted treatments were even more successful at reducing anxiety. And finally, treatment that was sustained over a long period of time resulted in less anxious symptoms as opposed to short-term treatments. With that said, long-term, parental-assisted CBT is best at reducing anxiety for children with ASD. I was curious as to why parental involvement was important. It turns out, parents are able to gain a better understanding of challenges experienced by the child. This produces empathy. Parents learn how their child thinks during a situation and why a child might have acted the way they did. They get a sense of their “meaning-making system” and can begin to see where problematic behavior stemmed from problematic thoughts. Cognitive behavioral therapy reshapes inaccurate and negative thinking patterns. It can alter the way we see ourselves, and as the research has shown, can prove to be beneficial in managing and lessening anxiety disorders, especially in those on the autism spectrum. Changing our self-talk and the way we view the world can greatly impact our outlook. Learning to effectively communicate with ourselves is the basis of this therapy and has been shown to improve wellbeing. Going forward, be aware of how you talk to yourself. Use supportive and affirming phrases to increase self-esteem and confidence. Together we can change the narratives we tell ourselves.
References
Anderson, C. (2012). Cognitive Behavioral Therapy and Autism Spectrum Disorders | Interactive Autism Network. Iancommunity.org. https://iancommunity.org/cs/simons_simplex_community/cognitive_behavioral_therapy
Anxiety. (2021, January). National Autistic Society. https://www.autism.org.uk/advice-and-guidance/topics/mental-health/anxiety
Perihan, C., Burke, M., Bowman-Perrott, L., Bicer, A., Gallup, J., Thompson, J., & Sallese, M. (2019). Effects of Cognitive Behavioral Therapy for Reducing Anxiety in Children with High Functioning ASD: A Systematic Review and Meta-Analysis. Journal of Autism and Developmental Disorders. https://doi.org/10.1007/s10803-019-03949-7