Facing Your Fears

Facing Your Fears (FYF) is a program aimed toward youth with high-functioning Autism Spectrum Disorders who need assistance managing anxiety symptoms that interfere with daily life. 

The program is based on more than 13 years of funded research, and uses cognitive-behavioral principles to assist youth in identifying their anxiety and/or fears, as well as learning strategies to manage their anxiety symptoms. FYF is currently offered in a group setting, although it may also be used in individual contexts.

A well-developed parent education component is part of the FYF program, and allows for the generalization of concepts and strategies learned in group to be implemented at home.

Effectively managing anxiety symptoms can help children and adolescents become more successful in an academic setting and participate more fully in their daily lives.

We invite you to click the tabs below to find out more about the resources we offer through this program.

Groups are offered for verbally fluent children and adolescents with high-functioning autism spectrum disorders who need assistance managing anxiety that interferes with their daily lives. This group focuses on helping youth identify anxiety, worry, or fear and develop coping strategies. The group gives youth an opportunity to practice these new strategies with the guidance and support of group facilitators.

Parents are an integral part of the FYF groups and are asked to attend all of the sessions. A well-developed parent education component allows for the generalization of concepts and strategies learned in group to be implemented at home. 

We also offer a two-day training to organizations such as school districts, ASD specialty clinics, University clinics, and mental health centers interested in learning about Facing Your Fears. The purpose of this two-day training is to provide an overview of group cognitive behavior therapy (CBT) for managing the anxiety symptoms in children and adolescents with Autism Spectrum Disorders.  

Day One will offer a broad introduction to the topic, with specific talks on the development of anxiety disorders in youth with ASD and other talks on applying CBT strategies to this population.  Additional talks will focus on modifying CBT for adolescents, for youth with ASD and intellectual disabilities, and for school settings.  

Day Two is primarily intended for professionals who will be delivering CBT to youth with ASD and anxiety. Core components of CBT will be discussed in detail, including psychoeducation and graded exposure. The Facing Your Fears program, group therapy for managing the anxious symptoms of youth with ASD will be presented throughout the training, as an illustration of a group CBT program specifically designed for youth with ASD and anxiety.  The results of several treatment trials will be presented and clinical and research implications will be discussed. Videotaped examples and interactive small group activities will also occur throughout the training.

We have conducted trainings worldwide, including in Buenos Aires, Argentina, Dublin, Ireland, Toronto, Vancouver, Edmonton, and Regina, Canada​.
Please contact Dr. Judy Reaven at judy.reaven@ucdenver.edu​ for more information.

Anxiety is one of the biggest challenges faced by children with high-functioning Autism Spectrum Disorder. Help them conquer their fears and participate more fully in home, school, and community life with this innovative group therapy program for children 8-14 years old and their parents.

Ideal for small groups of 4-5 children but also effective in one-to-one therapy, this researched, ready-to-use program is a must for mental health professionals who work with children and families in clinical settings. Developed to address the specific needs and challenges of children with high-functioning ASD, Facing Your Fears can be effective because it:

  • targets specific fears or worries that interfere with day-to-day functioning at home and school
  • actively involves parents in every session - the key to helping children make progress and ensuring that families provide skillful, sensitive support
  • is backed by more than 12 years of funded research, including several clinical trials(see publications)
  • engages children with memorable, age-appropriate strategies for managing anxiety, from creating "worry bugs" to filming movies of themselves facing their fears
  • gives children repeated opportunities to practice their social interactions with others
  • uses the highly effective principles of cognitive-behavioral therapy
  • helps children and parents generalize the skills they learn in a group to other settings

Reaven, J., Blakeley-Smith, A., Nichols, S., & Hepburn, S. (2011). Facing Your Fears: Group Therapy for Managing Anxiety in Children with High-Functioning Autism Spectrum Disorders, Paul Brookes Publishing Company, Baltimore.   

Supporting Journal Articles and Chapters

Reaven, J., Moody, E., Klinger, L., Keefer, A., Duncan, A., O’Kelley, S., Meyer, A., Hepburn, S., & Blakeley-Smith, A. (In press). Training Clinicians to Deliver Group CBT to Manage Anxiety in Youth with ASD: Results of a Multi-Site TriaJournal of Consulting and Clinical Psychology.

Middleton, C., Moody, E., Blakeley-Smith, A., Duncan, A., Hepburn, S., Keefer, A., Klinger, L., Meyer, A., O’Kelley, S., & Reaven, J. (2018).  The relationship between treatment acceptability and youth outcome in group CBT for youth with ASD and anxiety. Journal of Contemporary Psychotherapy, 48, 123-132. doi.org/10.1007/s10879-018-9380-4

Conner, C., DeVries, L., & Reaven, J. (2018).  Cognitive-Behavioral Approaches for Treating Adolescents with ASD.  In Gelbar, N. (Ed.). Adolescents with Autism Spectrum Disorders.  Oxford University Press. 

Drmic, I., Aljuined, M., & Reaven, J. (2017).  Feasibility, acceptability and preliminary treatment outcomes in a school-based CBT intervention program for adolescents with ASD and anxiety in Singapore.  Journal of Autism and Developmental Disorders.  DOI 10.1007/s10803-016-3007-y

Reaven, J., & Willar, K. (2017). Group cognitive behavior therapy for children and adolescents with autism spectrum disorders and anxiety.  In Kerns, C., Wood, J., Storch, E., Renno, P., & Kendall, P.  Evidence Based Assessment and Treatment of Anxiety in Children and Adolescents with Autism Spectrum Disorder, Elsevier Press: London.

​Keefer, A., Kreiser, N., Singh, V., Blakeley-Smith, A., Duncan, A., Johnson, C., Klinger, L., Meyer, A., Reaven, J., & Vasa, R. (2016).  Intolerance of uncertainty predicts anxiety outcomes following CBT in Youth with ASD, Journal of Autism and Developmental Disorders, DOI 10.1007/s10803-016-2852-z. 

Hepburn, S.L., Blakeley-Smith, A., Wolff, B. & Reaven, J.A. (2015).  Telehealth delivery of cognitive-behavioral intervention to youth with autism spectrum disorder and anxiety:  A pilot study.  Autism:  International Journal of Research and Practice, 1-12, doi: 10.1177/1362361315575164. 

Reaven, J., Washington, L., Moody, E., Stern, J., Hepburn, S., & Blakeley-Smith, A. (2015).  Examining the relationship between parental anxiety and treatment response in children and adolescents with autism spectrum disorder and anxiety.  Journal of Autism and Developmental Disorders.  doi: 10.1007/s10803-015-2410-0. 
Reaven, J., and Wainer, A. (2015).  Children and adolescents with ASD and co-occurring psychiatric conditions: current trends in intervention.  In R. M. Hodapp, & D. J. Fidler (Eds.), International Review of Research in Developmental Disabilities (pp. 45–90). ISBN: 9780128021811.  Elsevier Inc. Academic Press.   

Reaven, J., Blakeley-Smith, A., & Hepburn, S. (2014). Bridging the research to practice gap in autism research: Implementing group CBT interventions for youth with ASD and anxiety in clinical practice. In T. Davis, S. White, & T. Ollendick (Eds.), Handbook of Autism and Anxiety. New York, NY: Springer.

Reaven, J., Blakeley-Smith, A., Leuthe, E., Moody, E., & Hepburn, S. (2012). Facing your fears in adolescence: Cognitive-behavioral therapy for high-functioning autism spectrum disorders and anxiety. Autism Research and Treatment. Advance online publication. doi:10.1155/2012/42390

Blakeley-Smith, A., Reaven, J., Ridge, K., & Hepburn, S. (2012).  Parent-child agreement of anxiety symptoms in youth with autism spectrum disorders. Research in Autism Spectrum Disorders, 6, 707-716. doi: 10.1016/j.rasd.2011.07.020  
Reaven, J., Blakeley-Smith, A., Culhane-Shelburne, K., & Hepburn, S. (2012). Group cognitive behavior therapy for children with high-functioning autism spectrum disorders and anxiety: A randomized trial.  Journal of Child Psychology and Psychiatry, 53, 410-419. doi:10.1111/j.1469-7610.2011.02486.
Reaven, J. (2011). The treatment of anxiety symptoms in youth with high-functioning autism spectrum disorders:  Developmental considerations for parents. Brain Research, 1380, 255-263.    
Kaiser, K. (2011). Telehealth: Families Finding Ways to Connect in Rural Colorado. Exceptional Parent, 41(4), 18-19. ISSN-0046-9157
Reaven, J., Blakeley-Smith, A., Nichols, S., Dasari, M., Flanigan, E., Hepburn, S. (2009). Cognitive-Behavioral Group Treatment for Anxiety Symptoms in Children With High-Functioning Autism Spectrum Disorders: A Pilot Study. Focus on Autism and Other Developmental Disabilities, 24(1), 27-37.
Reaven, J.  (2009). Children with high-functioning autism spectrum disorders and co-occurring anxiety symptoms: Implications for assessment and treatment. Journal for Specialists in Pediatric Nursing, 14, 192-199. 
The clinical psychologists who created Facing Your Fears are clinicians and researchers.  Over the last 15 years, they have worked with many children and adolescents with autism spectrum disorder, who present with anxiety symptoms that interfere with their daily lives.  Through their clinical work and research, they developed an intervention that provides youth and their families with strategies and tools to better manage anxiety.

Meet the authors...

Judy Reaven, PhD, is a Professor of Psychiatry and Pediatrics, Director of Research and Associate Director of JFK Partners. She is also a licensed clinical psychologist and has worked in the field of developmental disabilities as a clinician, researcher, and educator since 1985. Her long-term clinical interests have included the co-occurrence of mental health symptoms in children and adolescents with autism spectrum disorders, which is what led to the development of the Facing Your Fears program. Dr. Reaven has been Principal Investigator on several research grants funded by both private foundations (Autism Speaks, Organization for Autism Research) and federal agencies (NIMH) which has assisted in the development of the Facing Your Fears program.  She is currently PI on a HRSA-funded grant focused on the implementation of FYF in public schools.  Dr. Reaven has authored numerous peer-reviewed publications on the topic of ASD and anxiety. 

Audrey Blakeley-Smith, PhD, is an Associate Professor of Psychiatry and Pediatrics, as well as Training Director for the University of Colorado Clinical Psychology Internship Program – Anschutz Medical Campus.  She is also a licensed clinical psychologist and has worked in the field of developmental disabilities since 1996. Her clinical interests include the assessment and treatment of co-occurring mental health issues in children with children and adolescents with autism spectrum disorders, as well as the development of school-based peer-mediated interventions for youth with ASD. Dr. Blakeley-Smith has been Principal Investigator on a school-based study exploring the use of peer-mediated interventions to reduce rejection and increase inclusion of children with autism, and is currently PI on a project modifying FYF for adolescents with ASD/IDD (both projects funded by OAR). 

Shana Nichols, PhD, is a licensed clinical psychologist and has worked in the field of autism spectrum disorders (ASDs) and child development since the mid 1990's. She has received research and service grant support for work in sexuality, puberty, healthy lifestyles, and ASDs and is the author of several peer-reviewed research articles and invited papers. Dr. Nichols currently specializes in adolescence and growing up, dual diagnosis and mental health, assessment and evaluation and the experiences of females with ASDs. She is lead author of the book Girls Growing Up on the Autism Spectrum: What Parents Should Know About the Pre-Teen and Teenage Years (Jessica Kingsley, 2008), with Gina Marie Moravick and Samara Pulver Tetenbaum. Dr. Nichols has worked as a clinician, researcher, administrator, graduate training supervisor, advisory board member, trainer and consultant in a wide variety of settings including outpatient clinics, residential programs, schools and the community.

Susan Hepburn, PhD, is a Professor in the Department of Human Development and Family Studies at Colorado State University.  She is also a licensed clinical psychologist, is actively involved in intervention and developmental research, and has published numerous articles in peer-reviewed journals. She has worked with many children with autism spectrum disorders, their families, and school teams, in the development of coping as well as other adaptive behavior skills. Dr. Hepburn was the Principal Investigator on a federally funded study (HRSA) called TeleCopes, a program focused on the adaptation of the Facing Your Fears program using telehealth to reach children with ASD in underserved communities in Colorado.

Funding that Supported this Research:
Training Outpatients Clinicians to Deliver Cognitive Behavior Therapy to Children Grant, National Institute of Health (Awards #R21MH089291 and 4R33MH089291-03) (2009-2014)

Tele-health Delivery of a Family-Focused Intervention to Reduce Anxiety in Youth with Autism Spectrum Disorders in Rural Colorado - Health Resources and Services Administration (Award #R40MC15593) (2009-2012)

Group Cognitive Behavior Therapy Intervention for Children with High-Functioning PDD’s and Anxiety Symptoms research funded by Organization for Autism Research, Autism Speaks, and Cure Autism Now (2004-2010)

University Center for Excellence in Developmental Disabilities Grant, Administration on Developmental Disabilities (Award # 90DD0632)

Leadership Education in Neurodevelopmental Disabilities Grant, Maternal Child Health Bureau (Award #T73MC11044)

Intellectual and Developmental Disabilities Research Center (IDDRC), NICHD funded Translational Neuroscience Nexus (Award# P30 HD004024-39)
TeleCopes was the telehealth version of the Facing Your Fears program and was developed through a study through funded from the Health Resources Service Administration (HRSA). The TeleCopes Project Director is Susan Hepburn, PhD, a licensed clinical psychologist at JFK Partners.
TeleCopes used videoconferencing technology to reach youth and their parents through their home computer. Families were paired with anywhere from 1-3 other families to create an online group therapy experience. In certain instances, individual therapy took place due to the child's needs.

Weekly sessions were scheduled between a clinician and all of the families in a particular group. They all connected online and could see and hear each other. The screen had one box for each family and showed the clinician and all the families on one screen.

Sometimes parent education was the focus of the session with some participation between the youth and other sessions focus on working with youth. Just like the live Facing Your Fears group participants, the TeleCopes participants completed a video that shows a strategy they adopted to help reduce their anxiety. Flipcams were sent to families to use in filming their video.

The TeleCopes program also reached out to families and teachers around the state who are interested in learning more about how they can support youth with ASD who experience anxiety. Interactive webinars were given by Susan Hepburn, PhD to address specific questions from parents and teachers.