Teenage Boys on the Autism Spectrum: A CBT Approach

In 2020, the Centers for Disease Control and Prevention (CDC) reported that approximately 1 in 54 children in the United States is diagnosed with Autism Spectrum Disorder (ASD). Boys are 4 times as likely to be diagnosed with ASD than girls. ASD is a condition related to a person’s brain development that impacts how one perceives and socializes with others. ASD also results in limited and repetitive patterns of behavior. ASD is a “spectrum” disorder in the sense that the types and severity of symptoms vary from individual to individual. Some people prefer to use the label “Asperger’s syndrome” to describe the mild or high-functioning end of the Autism spectrum. 

There are many available treatments for ASD. Depending on the individual’s level of functioning, Cognitive Behavioral Therapy (CBT) can be one effective treatment for individuals on the higher end of the spectrum. It is important to note that CBT (or any therapy for that matter) cannot move an individual from an ASD diagnosis to the status of being neurotypical (i.e., not diagnosed with ASD). CBT is effective at treating the secondary issues often related to the experience of being on the spectrum. Some of these issues include: 

  • Depression 
  • Anxiety 
  • Bullying 
  • Stress
  • Anger
  • Aggression
  • Social Skills deficits 

 What is CBT?

The goal of CBT is to help the client change the patterns of thinking or behavior that are contributing to the negative emotions they are struggling with.  CBT is based on the theory that events in themselves are not what upset us but rather the meaning we attribute to these events. Most of us have an internal dialogue in our heads, as though we were talking to ourselves. The tone of this inner dialogue is extremely critical and the perspective usually negative. Whenever we experience an event, a friend who forgets to call us or a bad grade on a quiz, we automatically assume the worst. We convince ourselves the friend did not call because he no longer likes us. We begin to believe we are stupid because we failed one quiz. These automatic thoughts are a filter that we use to assign meaning to what has happened to us. 

CBT is useful because it helps the person understand what is happening in their mind. It helps the person step outside the cycle of automatic thoughts and question whether their thoughts are actually true or useful. CBT would encourage the client whose friend failed to call to consider whether they were sick or unable to call for some other reason besides not liking the person any more. CBT would help the client who failed his quiz to consider the reasons why he did not perform as well and to develop a plan for how to succeed in the future. 

 CBT and High-Functioning Autism 

One of the biggest struggles teenage boys with Autism face is their social skills deficits. Many guys have a difficult time understanding nonverbal cues and don’t always know how to navigate complex social situations.  It is common for males on the spectrum to interpret a girl’s kindness as a romantic gesture. A teenage boy may interpret a girl’s smile as a sign that she is interested in dating him. CBT can help address this faulty reasoning by breaking down the social situation and analyzing each piece from a reasonable perspective. The therapist can help the client understand that a smile is a polite way of acknowledging someone and not necessarily a means of communicating romantic interest. The therapist can explain that misinterpreting a smile as a romantic gesture can lead to a situation where the girl feels awkward and the guy feels confused and embarrassed. Interpreting the smile in a realistic manner can help prevent the guy from the negative emotions associated with rejection. 

 Three Benefits of CBT 

Identifying Automatic Negative Thoughts 

The first step toward change is identifying the problem. CBT is designed to help teenage boys on the spectrum identify the automatic negative thoughts that are contributing to their undesirable behaviors and emotions. If the client has greater awareness of his thoughts, he has greater freedom to choose other thoughts that are more helpful.


Unlike other forms of therapy, CBT is direct and goal-oriented. The therapist and client work together to identify distorted thought patterns and figure out an action plan to change the thoughts and behaviors that are causing the problems. The client should leave each session with a clear sense of what he can be doing differently. 


CBT is a relatively brief therapy model. It does not take years to experience the therapeutic benefits of CBT. If the client can commit to a weekly schedule for a few months, he should experience tangible results.

Begin Counseling at Our Center in Katy, TX

If you are ready to help your teenage boy manage his anxiety or address social deficits, the therapists at The Center at Cinco Ranch can help! To begin counseling in Katy, TX, follow these three steps:
  1. Contact our office to set up an appointment or to get more information about CBT. 
  2. Meet with one of our skilled therapists
  3. Start taking control of your thoughts and experience greater freedom.                
Other Counseling Services: Other Services at the Counseling Center at Cinco Ranch

Our counseling services at The Counseling Center at Cinco Ranch include counseling for children and adolescents dealing with depression, self-injury, and school issues. We also provide services for family therapy, counseling for young adultstrauma counseling, anxiety treatmentcouples counseling, eating disorder treatment, and group counseling. Our therapists strive to regularly post blogs with helpful information on a variety of mental health topics. To learn more about our therapists and our counseling services, please reach out to the Center today!