Case study. Cognitive-behavioral therapy for nightmare disorder in a youth with comorbid autism spectrum disorder

Nightmares are often comorbid with other psychiatric disorders, including posttraumatic stress disorder (PTSD). Following treatment of comorbid conditions, nightmares may persist. Evidence in the adult treatment literature finds that nightmares respond to brief cognitive-behavioral treatments such as Exposure, Relaxation, and Rescripting Therapy (ERRT). Current research is adapting such treatments for children. The case presented is a 12-year-old cis-gender Native American girl with autism spectrum disorder. The youth suffered from several comorbidities and received inpatient care for suicide attempts in the year preceding treatment. Treatment aimed to mitigate nightmare frequency and distress. PTSD and sleep habits were also measured. Following the 5-module treatment, nightmare frequency and distress improved, PTSD declined, and parent-reported child sleep habits improved. Gains were maintained at the 6-month follow-up. Treatment implications and recommendations are discussed.