The Feasibility and Efficacy of Problem Solving Therapy in College Students with Autism Spectrum Disorders

Background:  

The need of students with Autism Spectrum Disorder (ASD) transitioning to college is an area that is gaining attention.  Such students have difficulty adapting to college due to increased academic demands, difficulty with organization, and social problems. These obstacles contribute to drop out, even in students with exceptional academic skills. Currently, there is no empirically-supported treatment designed to help students successfully adapt to the college environment. This study presents pilot data on a group-based cognitive behavioral intervention program, Problem-Solving Skills:101 (PSS:101) to address impaired problem-solving ability in ASD. PSS:101 was designed to promote problem-solving ability in college students with ASD who are likely to be struggling with academic, social, and emotional problems in a college setting. Though a manualized therapy specifically targeting problem-solving has never been used with college students with ASD, several empirical studies have successfully targeted this skill as a component of a larger intervention (Stichter et al., 2010). PSS: 101 is based on Problem-Solving Therapy (D’Zurilla & Nezu, 2007), an evidence-based, cognitive-behavioral intervention designed to promote an adaptive problem-solving attitude and teach skills to reduce psychopathology and enhance psychological functioning.

Objectives:  

Primary aims were to collect data on the feasibility of implementing PSS:101 and on the short-term efficacy of the intervention. Treatment feasibility is defined as a combination of treatment integrity (i.e., delivery of the intervention’s key elements), treatment adherence (i.e., participant attendance and engagement with treatment), and consumer satisfaction (i.e., participant ratings of satisfaction).

Methods:  

We are currently midway through the nine-week program. Five students with a previous diagnosis of ASD, confirmed by the ADOS (Lord et al., 2000) and AQ (Baron-Cohen et al., 2001), were recruited to participate in this ongoing study. During baseline evaluation, students completed measures of efficacy (e.g., problem-solving ability, general psychological distress). Students will attend 9 weekly group sessions lasting 1.5 hours each, co-led by two graduate students under supervision of a licensed clinical psychologist. Each week, group leaders complete measures of treatment integrity and students will complete measures of treatment adherence, consumer satisfaction, and efficacy. After PSS:101, students will complete measures of efficacy. Statistical modeling techniques will be used to assess each individual’s progress during therapy with respect to efficacy measures. Treatment integrity and adherence components will be calculated as percentages for each participant. Mean scores for consumer satisfaction will be calculated through questionnaires assessing helpfulness of sessions, therapy components, and homework. 

Results:  

Five students with ASD enrolled in PSS:101. Preliminary data from the first 6 sessions resulted in an attendance rate of 90%, 97% of treatment goals met, and 70% homework completion. Further analyses will be conducted after all data is collected.

Conclusions:  

If PSS:101 is feasible and potentially efficacious, it can be conducted with larger samples to test treatment efficacy in randomized controlled trials. With empirical support, it could be a cost-effective way for universities to support students with ASD. If hypotheses are not supported, changes based on therapist and group members’ feedback can be used to modify PSS:101 to be more aligned to students’ needs.