Program for the Education and Enrichment of Relational Skills (PEERS): Effectiveness In a Community-Based Mental Health Setting

Background:

Social skills training attempts to address one of the core deficits exhibited by individuals with autism spectrum disorders. The Program for the Education and Enrichment of Relational Skills (PEERS; Laugeson & Frankel, 2010) is a parent-assisted intervention for teens with autism that teaches social rules and routines to foster friendships. PEERS focuses on strategies for developing and maintaining friendships as a way to buffer the deleterious effects of social difficulties. The efficacy of the PEERS intervention was demonstrated by an increase in social knowledge and interactions for teens enrolled in PEERS relative to teens in a delayed treatment control group (Laugeson, Frankel, Mogil, & Dillon, 2009). 

Objectives:

This study examined the effectiveness of PEERS in a community-based mental health setting.

Methods:

Participants included seven adolescents (range: 13-18 years old; four males) and their parents. Inclusion criteria were less restrictive than those used in Laugeson et al. (2009), so participants in the group included teens with an autism spectrum disorder, ADHD, apraxia, major depression, anxiety, and adjustment disorder. Four therapists with graduate training implemented the intervention and fidelity was maintained through weekly supervision with one therapist who is a clinical psychologist trained by the developers of PEERS to administer the intervention. Teens and parents completed the four outcome measures that yielded significant differences in the initial efficacy study. Teens completed the Test of Adolescent Social Skills Knowledge (TASSK; Laugeson & Frankel, 2006), Friendship Qualities Scale (FQS; Bukowski, Hoza, & Boivin, 1994), and the Quality of Socialization Questionnaire for Adolescents (QSQA; Frankel & Merkel, 2008), and parents completed the Social Skills subscale of the Social Skills Improvement System (SSIS; Gresham & Elliott, 2008). Parents also completed the TASSK as an additional measure of social skills knowledge gained during PEERS.

Results:

Results reflect within-subjects outcome data at the end of the 14-week intervention. Paired t-tests were conducted with a correction for multiple comparisons (a=.01). Results revealed that teens (p=.004, Cohen’s d=1.30) and parents (p<.001, d=2.7) showed an increase in their knowledge of social skills on the TASSK. In contrast, there was no significant change (all ps>.1) reported for general social skills (SSIS Social Skills subscale, d=.7), quality of friendships (FQS, d=.03), and frequency of social get-togethers hosted by teens (QSQA, d=.8).

Conclusions:

This study demonstrated that the PEERS model could be applied in a clinical, community-based mental health setting with a heterogeneous group of teenagers with impairments in social functioning. Preliminary findings suggest that teen and parent participants reported an increase in their knowledge of social skills (TASSK), but the quality (FQS/SSIS Social Skills) and quantity (QSQA) of social interactions did not show significant improvement post-intervention. Effect sizes for the SSIS Social Skills subscale and QSQA suggest that failure to detect differences on these measures may have resulted from the small sample size and lack of statistical power. Furthermore, while teens may have learned the skills presented during the PEERS intervention, additional practice with generalization may be needed to facilitate an increase in the quality and quantity of real world, social experiences.