The Cognitive Behavioral Therapy for Autistic Adults Provider Training (CBT-AAPT) is a curriculum composed of modules designed to improve the attitudes of mental health providers towards autistic adults, increase their knowledge about autism, and acquire clinical skills specific to autistic adults. The target learner for CBT-AAPT are MHPs without formal clinical training in autism.

     The objectives of the CBT-AAPT curriculum for MHPs are to:

• improve the understanding of the needs of autistic adults in a holistic fashion;
• develop the competency of assessing the strengths of autistic adults;
• integrate principles of Strengths-Based Model of Neurodiversity (SBMN) to existing CBT treatment philosophy;
• incorporate new approaches of capturing perceived situations and automatic thoughts from autistic adults; and
• adapt existing CBT interventions to meet the needs of autistic adults.

Collectively, these objectives are aimed at increasing providers’ abilities to engage with autistic adults and deliver the modified form of CBT to autistic adults more effectively.

     The essential components of CBT-AAPT include the following:

• Knowledge about autistic adults: differential diagnoses of autism, heterogeneity of the autism population, co-occurring conditions, common challenges in independent living, employment challenges.
• Knowledge about approaches to support autistic adults: co-occurring conditions (anxiety, depression), common problems (emotion regulation, communication), safety, health and wellness, transportation. Modifications to traditional CBT programs adapted to neuropsychological features of autism are discussed. Examples may include visual aids, highly structured sessions, and flexibility in the length and number of sessions. Other modifications include multiple-choice rather than open-ended questions.
• Knowledge about evidence-based treatment approaches: non-pharmacologic treatments, principles behind providing pharmacologic treatments for common problems in autistic adults such as inattention, hyperactivity, impulsivity, irritability & associated aggressive behaviors, mood symptoms, and anxiety.
• Clinical skills on diagnosis and treatment: through case discussions. CBT-AAPT will include 14 weekly sessions to be delivered to MHPs.

CBT-AAPT is derived from existing literature on autistic adults developed by the course co-director (Gaus, 2019), SBMN developed by the course director (Fung, 2021), strategies to adapt typical CBT approaches to treatment for autistic adults, and materials co-developed by neurotypical and autistic adults. The SBMN adopts the principles of positive psychology (Seligman & Csikszentmihalyi, 2000) and positive psychiatry (Jeste, 2018), uses the theory of multiple intelligences (Gardner & Hatch, 1989) as the rubric to help autistic adults develop their strengths and interests, and incorporates the Chickering’s seven vectors of development (Chickering & Reisser, 1993) to systematically enhance the development of neurodiverse individuals.

Course Schedule

June 8, 2023 – Course Introduction (LIVE)

June 15, 2023 – Clinical knowledge (Asynchronous)

June 22, 2023 – Case discussions (LIVE)

1. Explain how to conceptualize mental health problems of autistic adults using a CBT framework
2. List guidelines for establishing therapeutic alliance with autistic adults
3. Identify relevant cases in their own clinical work

June 29, 2023 – Clinical knowledge (Asynchronous)

1. Describe common developmental trajectories of autistic individuals
2. Explain challenges of autistic individuals in educational and employment settings
3. Describe how to use an individualized case-formulation for treatment planning
4. Identify one case to use from their own work as a practice example 

July 6, 2023 – Clinical knowledge (Asynchronous)

1. Discuss approaches to assess the strengths of the autistic patient
2. Explain common cognitive distortions in the autistic patient

July 13, 2023 – Clinical skills – live demonstrations, case consultations and discussions (LIVE)

1. List the major categories of core ASD factors that may contribute to the mental health problems presented by autistic patients
2. Describe modified CBT strategies that can help improve core ASD issues that are impacting autistic patients’ mental health

July 20, 2023 – Clinical skills – live demonstrations, case consultations and discussions (LIVE)

1. Discuss case examples of emotion regulation challenges
2. Describe mindfulness-based CBT (“third wave”) approaches that can improve emotion regulation skills in autistic patients

July 27, 2023 – Clinical skills – recorded illustrations (Asynchronous)

1. List common co-occurring anxiety disorders for autistic patients
2. Describe CBT strategies to address anxiety symptoms

August 3, 2023 – Clinical skills – live demonstrations, case consultations and discussions (LIVE)

1. Articulate how to apply strengths-based approaches in conducting CBT in autistic patients
2. Describe treatment strategies that can improve social cognition skills in autistic patients
3. Discuss special considerations when implementing CBT for co-occurring Social Anxiety Disorder in autistic patients

August 10, 2023 – Clinical skills – recorded illustrations (Asynchronous)

August 17, 2023 – Clinical skills – recorded illustrations (Asynchronous)

1. Discuss unique ways depressive symptoms may be expressed in autistic patients
2. Describe CBT strategies to address depressive symptoms

August 24, 2023 – Clinical skills – recorded illustrations (Asynchronous)

1. Explain common PTSD-related scenarios in autistic patients
2. Describe approaches to handle PTSD in autistic patients

August 31, 2023 – Clinical skills – live demonstrations, case consultations and discussions (LIVE)

September 7, 2023 – Conclusion and Recap (LIVE)

1. Describe approaches to adapt CBT in addressing issues associated with core characteristics of autism 
2. Discuss at least one case where CBT was applied to address a mental health problem in an autistic adult