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UBC Theses and Dissertations

A preliminary evaluation of a modified school-based facing your fears for students with autism spectrum disorder and anxiety Kester, Karen R.


Anxiety is common in children with autism. Although there has been a steady increase in the empirical evidence demonstrating successful treatment of anxiety in children with ASD using Cognitive Behavioural Therapy (CBT), there is little research on implementing CBT in the school setting. With a high prevalence of anxiety among youth with ASD, researchers have identified implementing effective treatments in real-world settings as a top priority. Thus, this dissertation, consisting of two related studies, examined the adaptation for and delivery of the Facing Your Fears (FYF) program in the school setting. Using an integrated knowledge translation framework (iKT), knowledge user’s perspectives on the acceptability, feasibility, and sustainability of delivering FYF in a school setting were examined in Study 1. Qualitative data were collected through focus group discussions and analyzed using thematic analysis techniques. The insights provided by educators and parents regarding the strengths, barriers and practical considers for implementation of FYF in the school setting were used to inform provisions to FYF, resulting in a proposed modified school-based FYF intervention. In study 2, a quasi-experimental group design along with semi-structured interviews and focus groups were used to evaluate the effectiveness of educators implementing the modified school-based FYF to treat anxiety among students with ASD. Qualitative data were analysed using thematic analysis. Results are discussed in terms of skill acquisition, preliminary treatment outcomes, and social validity. Results indicated that with training and on-going feedback educators obtained a modest level of fidelity in implementing the intervention. Non-significant decreases in student anxiety symptoms across all informant ratings (students, parents and teachers) were observed. Social validity ratings across participants were high with the following themes emerging from the data: (a) outcomes; (b) program structure; (c) inclusion; and (d) recommendations. These results provide a step forward in the promotion of anxiety treatment for children with ASD in school settings. Specifically, they offer a model for researchers to collaborate with key stakeholders in adapting interventions for use in schools, thereby, bridging the gap between research and practice. Importantly, they highlight educator’s capability in delivering empirically-supported treatments to address anxiety among students with ASD.

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