Facing Your Fears in Schools
van Steensel, F. J., & Heeman, E. J. (2017). Anxiety levels in children with autism spectrum disorder: A meta-analysis. Journal of Child and Family Studies, 26(7), 1753-1767. https://doi.org/10.1007/s10826-017-0687-7
What is Facing Your Fears in Schools (FYF-S)?
FYF-S was derived from the original FYF but adapted via community input to meet the needs of autistic students with anxiety in school settings. FYF-S is delivered by interdisciplinary school providers to small groups of students (2-5 students) with autism or similar social/communication differences and anxiety in elementary and middle schools. FYF-S can also be delivered individually. Like the original program, FYF-S is a CBT-based program and includes psychoeducation, graded exposure activities, and intervention activities are designed to be accessible to a range of learners.
Worksheets are used liberally throughout the program and include engaging graphic representations of diverse students alongside clear written directions and multiple-choice lists. Brief “hands-on” activities are incorporated throughout the program and are intended to enhance the accessibility of CBT content for different learners. FYF-S is shorter in duration than FYF, with twelve, 40-minute lessons.
Caregivers are involved in the school-based program, although their involvement is far less than what occurs in the clinic program. In FYF-S, caregivers receive weekly handouts summarizing student activities, are asked to attend one caregiver meeting and watch a short video introducing exposure. Common worries/fears addressed in FYF-S have included fire alarms, using the school bathroom, talking in class, talking to adults and/or peers, making mistakes, worrying about not knowing/understanding schoolwork, arriving late to school, losing a game, and changes in routine.
Who is FYF-S for?
Students (ages 8-14) with autism or similar social communication differences and anxiety interfere in an ongoing way in school activities. Neurodivergent students with social communication and/or learning differences may also benefit from the program. FYF-S was not designed for students with significant cognitive and/or language difficulties (e.g., students with known intellectual disabilities).
Who can deliver FYF-S?
Our research has indicated that interdisciplinary school providers (e.g., school psychologists, counselors, social workers, special education teachers, speech/language pathologists, occupational therapists, and others) can effectively deliver FYF-S with training and consultation. The extent to which FYF-S can be delivered without training/consultation is unknown, particularly for providers with limited experience in working with autistic students and/or with CBT approaches.
FYF-S was informed via 14 focus groups comprised of school providers, administrators, and caregivers of autistic youth and was designed to be a user-friendly manual so that providers from different disciplinary backgrounds could deliver the program with limited training. Because the program addresses mental health symptoms, it is recommended that school providers who deliver FYF-S include a mental health provider (school psychologist, counselor, or social worker). If it is not possible to include a mental health provider in direct delivery, then it is strongly recommended that the group facilitators consult with a mental health provider.
Getting Started-schools/school providers:
School mental health providers with a background in CBT for managing anxiety may be able to deliver FYF-S without formalized training (see Reaven et al. 2022; 2024). For non-mental health school providers, or for school mental health providers with limited knowledge about using CBT for autistic youth with anxiety, attending a training is recommended.
Accessing Manuals:
The Facing Your Fears in Schools (FYF-S) manual can be purchased through Brookes Publishing. Student and parent workbooks are available in fillable PDF format with the purchase of the facilitator manual. Student workbooks are also available for purchase in a 5 pack at Brookes Publishing.