Making the Right Referrals: Clinical Decision-Making Guidelines

Clear referral guidelines help professionals identify which young people will benefit most from PEERS and how the program complements other therapeutic interventions. 

The ideal candidates for PEERS demonstrate specific characteristics that predict positive engagement with the program's methodology. Most critically, prospective participants should express motivation to develop friendships, even if this motivation coexists with social anxiety or past negative experiences¹. This motivational component distinguishes PEERS from interventions appropriate for young people who may require more foundational social awareness development before tackling peer relationships². Additionally, candidates should possess sufficient cognitive and language abilities to process the curriculum's verbal content, with general guidelines suggesting verbal IQ ≥70³, though adaptations exist for those with more significant cognitive challenges through the PEERS for Adolescents with Diverse Abilities curriculum variant⁴. 

PEERS complements rather than replaces other therapeutic interventions, functioning optimally within a comprehensive support approach⁵. For young people receiving cognitive-behavioral therapy for anxiety or depression, PEERS provides concrete social tools that support therapeutic goals around behavioral activation and exposure⁶. For those working with speech-language therapists on pragmatic communication, PEERS extends this work into peer-specific contexts⁷, addressing the significant gap between clinic-based communication exercises and real-world social demands. The program similarly enhances occupational therapy interventions addressing social participation barriers, providing specific strategies that build upon foundational sensory processing and self-regulation support⁸. 

Timing considerations play a crucial role in referral decisions, with several indicators suggesting readiness for PEERS. Young people experiencing increased social motivation but continued social difficulties following other interventions often benefit from PEERS' concrete approach⁹. Similarly, those approaching transition periods—moving to secondary school, preparing for post-school placements, or experiencing increasing social expectations with age—represent appropriate referrals as these transitions typically involve significant shifts in social demands¹⁰. The program further benefits young people whose mental health difficulties appear connected to social challenges, where addressing social skills directly may reduce anxiety, improve mood, or decrease behavioral difficulties stemming from social frustration¹¹. 

References 

¹ Laugeson, E. A., & Frankel, F. (2010). Social Skills for Teenagers with Developmental and Autism Spectrum Disorders: The PEERS Treatment Manual. Routledge. 

² Laugeson, E. A., Frankel, F., Mogil, C., & Dillon, A. R. (2009). Parent-assisted social skills training to improve friendships in teens with autism spectrum disorders. Journal of Autism and Developmental Disorders, 39(4), 596–606. https://doi.org/10.1007/s10803-008-0664-5 

³ Laugeson, E. A., & Park, M. N. (2014). Using a CBT approach to teach social skills to adolescents with autism spectrum disorder and other social challenges: The PEERS® method. Journal of Rational-Emotive & Cognitive-Behavior Therapy, 32(1), 84–97. https://doi.org/10.1007/s10942-014-0181-8 

⁴ Laugeson, E. A. (2017). PEERS® for Young Adults: Social Skills Training for Adults with Autism Spectrum Disorder and Other Social Challenges. Routledge. 

⁵ Laugeson, E. A., Frankel, F., Gantman, A., Dillon, A. R., & Mogil, C. (2012). Evidence-based social skills training for adolescents with autism spectrum disorders: The UCLA PEERS program. Journal of Autism and Developmental Disorders, 42(6), 1025–1036. https://doi.org/10.1007/s10803-011-1339-1 

⁶ Laugeson, E. A., & Park, M. N. (2014). Ibid. 

⁷ Gantman, A., Kapp, S. K., Orenski, K., & Laugeson, E. A. (2012). Social skills training for young adults with high-functioning autism spectrum disorders: A randomized controlled pilot study. Journal of Autism and Developmental Disorders, 42(6), 1094–1103. https://doi.org/10.1007/s10803-011-1350-6 

⁸ Laugeson, E. A., & Frankel, F. (2010). Ibid. 

⁹ Laugeson, E. A., Frankel, F., Mogil, C., & Dillon, A. R. (2009). Ibid. 

¹⁰ Laugeson, E. A., Frankel, F., Gantman, A., Dillon, A. R., & Mogil, C. (2012). Ibid. 

¹¹ Laugeson, E. A., & Park, M. N. (2014). Ibid.