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Research Summary

Group Cognitive Behavioural Therapy and Group Recreational Activity Are Both Beneficial for Adults With Autism

Jordan Cleland | York University
This article summarizes a study that examined cognitive behavioural therapy (CBT) and recreational therapy for young autistic adults with mental health concerns. Beneficial outcomes were found in both intervention types; however, some differences were noted.

What you need to know

There are few treatment options available for adults with ASD. Group settings reduce social isolation by providing opportunities for people to interact with one another. This study found that group cognitive behavioural therapy and social recreational activities interventions resulted in beneficial outcomes,  equally effective at increasing self-reported quality of life, happiness, and self-acceptance.


What is this research about?

There is an urgent need to identify effective treatment options for adult psychiatric individuals with ASD. Currently, there are very few options for adults with ASD, generally consisting of regular recreational activities, social training, and symptom-specific programs. Group settings enable social interaction and reduce social isolation. For adults with ASD, regular recreational activities have been associated with better quality of life. On the other hand, cognitive behavioural therapy (CBT) provides structure and predictability that many individuals with ASD seek. From comparing different interventions, certain elements seem beneficial to adults with ASD: (1) group setting, (2) structure and predictability, (3) psycho-education, (4) social training, and (5) ASD-suitable CBT techniques. The authors decided to implement and compare two group interventions: modified group CBT for adults with ASD, and the regular group recreational activities.


What did the researchers do?

Participants were recruited through referrals and were randomly assigned to the two intervention groups. Fifty-four participants completed the interventions. They were young adults, with an average age of 32 years old, and the majority had serious mental health concerns (including suicide attempts, other psychiatric conditions, and treatment with psychotropic medications). Both groups were given 36 sessions (3 hours each) of either the modified CBT intervention or the recreational activity intervention. The CBT intervention was administered in a structured group setting and divided into three themes: (1) self-esteem and ASD awareness, (2) social contacts and everyday life, and (3) psychological and physical health. The recreational activity intervention was designed to increase social interaction and break social isolation. The therapists in this intervention did not use any therapeutic techniques, but relied solely on the structure and group setting. The group did activities like museum visits, cooking, and taking walks.


What did the researchers find?

Both interventions were equally effective in increasing quality of life and psychological wellbeing. The increases were maintained at follow-ups ranging from 8 months to 2 years after treatment. However, there were no changes in psychiatric health or functioning as measured by the scales, although two-thirds of the participants felt as though they had improved. After the treatments, participants from both groups said that they accepted themselves more (62%), that they felt happier (49%), and that they had more social contact (28%). The CBT group reported a better understanding of themselves and how to express their needs due to the psycho-education, compared to the other group. The CBT group also had a lower dropout rate during the study than the other group, which the authors believe was because of the location (clinic-based versus public facilities).


How can you use this research?

These results highlight the importance of the group setting for people with ASD, as both interventions were good treatment options for this population. This study adds insight to the development of treatment options for adults with ASD.


About the Researchers

The authors are researchers in the Department of Clinical Neuroscience at the Karolinska Institute in Sweden.



Hesselmark, E., Plenty, S., & Bejerot, S. (2014). Group cognitive behavioural therapy and group recreational activity for adults with autism spectrum disorders: A preliminary randomized controlled trial. Autism, 18(6), 672-683



This research summary was written by Jordan Cleland for the Chair in Autism Spectrum Disorders Treatment and Care Research. This research summary, along with other summaries, can be found on our blog and at


Reproduced with the permission of Dr. Jonathan Weiss (York University). This research summary was developed with funding from the Chair in ASD Treatment and Care Research. The Chair was funded by the Canadian Institutes of Health Research in partnership with Autism Speaks Canada, the Canadian Autism Spectrum Disorders Alliance, Health Canada, Kids Brain Health Network (formerly NeuroDevNet) and the Sinneave Family Foundation. This information appeared originally in the Autism Mental Health Blog (

Photo by Kate Kalvach on Unsplash

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