Une évaluation qualitative des composantes de la thérapie cognitivo-comportementale pour l'anxiété sociale chez des adultes autistes : expériences vécues d'un programme de groupe modifié

Titre original en anglais : A qualitative evaluation of cognitive-behavioural therapy components for social anxiety in autistic adults: Lived experiences from a modified group program

Cette publication est incluse dans le projet « Contributions académiques de personnes autistes sur l’autisme ». Au moins un auteur·ice est autiste ; la publication ne divulgue pas l’identité de tou·tes les auteur·ices autistes.

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Roisenberg, B. B., Boulton, K. A., Thomas, E. E., Perry, N., Yu, D., & Guastella, A. J. (2026). A qualitative evaluation of cognitive-behavioural therapy components for social anxiety in autistic adults: Lived experiences from a modified group program. Autism, 30(5), 1147-1164. https://doi.org/10.1177/13623613261424830

Date de publication: 26/03/2026 Ajout dans AutiHub: 18/10/2026 Type: Article Langue de l’article: Anglais
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Auteurs

Auteur·ices des publications
6
Auteur·ices autistes mentionné·es dans la publication
Au moins 1
  1. Bruna B Roisenberg
  2. Kelsie A Boulton
  3. Emma E Thomas
  1. Nina Perry
  2. Dorothy Yu
  3. Adam J Guastella

Résumé

La thérapie cognitivo-comportementale (TCC) est un traitement fondé sur des données probantes pour l'anxiété sociale. Cependant, malgré la forte prévalence de l'anxiété sociale chez les adultes autistes, on en sait beaucoup moins sur la manière dont les personnes autistes vivent chaque composante de la TCC utilisée dans le traitement. Cette étude qualitative explore les perspectives d'adultes autistes concernant un programme de groupe modifié de thérapie cognitivo-comportementale pour l'anxiété sociale, en se concentrant sur l'efficacité perçue des composantes de la TCC et sur l'identification des modifications nécessaires. Vingt-sept participants ayant achevé l'intervention ont pris part à des entretiens semi-structurés. Une analyse thématique a identifié des thèmes centraux liés à l'impact thérapeutique (application des stratégies de TCC en groupe) et aux expériences des participants (suggestions pour les futures versions des groupes sociaux). Dans l'ensemble, les tâches d'exposition ont été considérées comme utiles pour réduire l'anxiété, particulièrement lorsqu'elles étaient structurées et prévisibles. La restructuration cognitive a souvent été vécue comme efficace ; toutefois, son impact était parfois limité par des croyances fondamentales persistantes et profondément ancrées, ainsi que par des expériences négatives passées. Les stratégies sociales et les compétences de gestion de l'anxiété ont été appréciées pour leur format structuré et leurs éléments éducatifs, mais leur généralisabilité a parfois été soulevée comme une limite. Les participants ont également recommandé des adaptations supplémentaires, notamment une flexibilité dans la présentation du contenu et des modifications de l'environnement physique. Les résultats soulignent un soutien global aux composantes de la thérapie cognitive pour réduire l'anxiété sociale chez les adultes, mais également l'intérêt d'adapter les approches de TCC aux besoins des adultes autistes. Les résultats de cette étude offrent des orientations pratiques provenant de personnes autistes afin d'améliorer l'acceptabilité et l'efficacité de futures interventions de TCC. Résumé grand public De nombreux adultes autistes éprouvent de l'anxiété sociale, ce qui peut rendre les interactions quotidiennes stressantes ou accablantes. Pour aider à cela, des chercheurs cliniciens ont élaboré un programme de thérapie de groupe fondé sur une thérapie cognitivo-comportementale adaptée aux adultes autistes. Bien que la thérapie cognitivo-comportementale soit couramment utilisée pour traiter l'anxiété, relativement peu de recherches ont examiné la manière dont les personnes autistes vivent les versions de groupe de cette thérapie. Cette étude visait à comprendre ce que les participants pensaient du programme et comment il pourrait être amélioré. L'intervention comprenait huit séances de groupe au cours desquelles les participants ont appris des informations sur l'anxiété sociale et l'autisme, des stratégies sociales, et ont participé à des activités guidées visant à renforcer leur confiance. Le programme encourageait un environnement de soutien dans lequel les personnes autistes pouvaient essayer en toute sécurité de nouvelles façons d'entrer en relation avec les autres sans ressentir de pression à dissimuler qui elles sont. Afin de comprendre dans quelle mesure le programme était utile, les chercheurs ont interrogé les participants sur leurs expériences. Beaucoup ont déclaré que le programme les avait aidés à se sentir plus confiants et moins anxieux dans les situations sociales. Par exemple, ils ont trouvé les jeux de rôle dans un cadre de groupe sécurisant particulièrement utiles. Les participants ont également apprécié que la thérapie soit adaptée à leurs besoins. Toutefois, l'étude a également mis en évidence certains domaines à améliorer. Certains participants ont trouvé certaines parties du programme difficiles, en particulier les activités ou les contextes non structurés. D'autres ont suggéré que le programme pourrait être plus flexible, proposer des instructions plus claires ou être mieux préparé pour les personnes ayant eu des expériences négatives passées avec la thérapie. Ces premiers résultats suggèrent que la thérapie cognitivo-comportementale peut être efficace lorsqu'elle est adaptée de manière réfléchie aux adultes autistes. Ce travail contribue à jeter les bases de services de santé mentale plus inclusifs et informés par l'autisme, qui soutiennent la confiance sociale d'une manière ressentie comme sûre et valorisante.

Cognitive-behaviour therapy (CBT) is an evidence-based treatment for social anxiety. However, despite the high prevalence of social anxiety among autistic adults, much less is known about how autistic people experience each CBT component used in treatment. This qualitative study explores autistic adults’ perspectives on a modified cognitive-behaviour therapy group programme for social anxiety, focusing on the perceived effectiveness of CBT components and the identification of needed modifications. Twenty-seven participants who completed the intervention took part in semi-structured interviews. Thematic analysis identified core themes related to therapeutic impact (application of CBT group strategies) and participant experiences (suggestions for future iterations of social groups). Overall, exposure tasks were viewed as helpful in reducing anxiety, particularly when structured and predictable. Cognitive restructuring was often experienced as effective; however, its impact was sometimes limited by persistent and deeply held core beliefs and past negative experiences. Social strategies and anxiety management skills were appreciated for their structured format and educational elements, but generalizability was sometimes raised as a limitation. Participants also recommended additional adaptations, including flexibility in content delivery and modifications to the physical environment. Findings highlight overall support of cognitive-therapy components for reducing social anxiety in adults, but also benefit to tailoring CBT approaches to theneeds of autistic adults. Results from this study offer practical guidance from autistic people to enhance the acceptability and effectiveness of future CBT interventions. Lay abstract Many autistic adults experience social anxiety, making everyday interactions feel stressful or overwhelming. To help with this, clinical researchers developed a group therapy programme based on cognitive-behaviour therapy adapted for autistic adults. While cognitive-behaviour therapy is commonly used to treat anxiety, there has been relatively little research into how autistic people experience group-based versions of this therapy. This study aimed to understand how participants felt about the programme and how it could be improved. The intervention included eight group sessions where participants learned about social anxiety and autism, social strategies and took part in guided activities to build confidence. The programme encouraged a supportive environment where autistic individuals could safely try out new ways of connecting with others without feeling pressure to hide who they are. To understand how helpful the programme was, researchers interviewed participants about their experiences. Many said the programme helped them feel more confident and less anxious in social situations. For example, they found role-playing in a safe group setting especially useful. Participants also appreciated that the therapy was adapted to suit their needs. However, the study also highlighted some areas for improvement. Some participants found parts of the programme challenging, especially unstructured activities or settings. Others suggested the programme could be more flexible, offer clearer instructions or be better prepared for people who had past negative experiences with therapy. These early findings suggest that cognitive-behaviour therapy can be effective when thoughtfully adapted for autistic adults. This work helps lay the foundation for more inclusive, autism-informed mental health services that support social confidence in a way that feels safe and empowering.

Bibliographie citée par cette référence

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Vue d’ensemble de la bibliographie citée

Ces indicateurs décrivent la bibliographie citée par cette publication. Un nom d’auteurice est compté chaque fois qu’il apparaît dans une référence citée : une même personne peut donc être comptée plusieurs fois. Les noms qui ne sont pas encore associés à un·e auteurice déjà présent·e dans AutiHub sont traités comme inconnus, pas comme non autistes. Dernier calcul : 23/10/2026 08:00.

Références citées
75
Avec un DOI
69
Sans DOI, à partir du texte brut de la bibliographie
6
6 / 75 (8,0 %) références citées comprennent au moins une personne identifiée comme autiste.
Références avec données à compléter
2 / 75 (2,7 %)
Références avec noms d’auteurices détectés
73 / 75 (97,3 %)
Sans nom d’auteurice détecté
2
Sans titre structuré
2
Sans identifiant stable
6
Références avec noms bruts d’auteurices restant à vérifier
2
Références avec problème de récupération des métadonnées externes
0
Ces indicateurs portent sur les références citées affichées sur cette page, après fusion des doublons techniques. Une référence sans DOI peut quand même soutenir les statistiques d’auteurices lorsqu’un titre et des noms d’auteurices sont disponibles.
Noms d’auteurices détectés dans la bibliographie citée
328
À partir du DOI ou de métadonnées externes
328
À partir du texte brut validé de la bibliographie
0
Noms bruts déjà validés
0
Noms bruts restant à vérifier
6
128 / 328 (39,0 %) noms sont associés à un·e auteurice déjà présent·e dans AutiHub. 200 / 328 (61,0 %) noms ne sont pas encore associés.
Noms associés à une personne identifiée comme autiste
16 / 328 (4,9 %)
Calculé sur l’ensemble des noms d’auteurices détectés dans la bibliographie citée. Parmi les noms associés à un·e auteurice déjà présent·e dans AutiHub : 16 / 128 (12,5 %). Personnes distinctes identifiées comme autistes : 16 / 278 (5,8 %).
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