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Published on: November 25, 2025
Metacognitive therapy versus exposure and response prevention for pediatric obsessive-compulsive disorder. A case
Michael Simons1, Silvia Schneider, Beate Herpertz-Dahlmann
1Department of Child and Adolescent Psychiatry, RWTH Aachen University, Aachen, Germany. msimons@ukaachen.de
Background:
Exposure with ritual prevention (ERP) is the psychotherapeutic treatment of choice for pediatric obsessive-compulsive disorder (OCD). In the present study, a new treatment rationale - metacognitive therapy (MCT) for children - was developed and evaluated.
Methods:
Ten children and adolescents with OCD were randomly assigned to either MCT or ERP therapy condition. Patients were assessed before and after treatment and at the 3-month and 2-year follow-up by means of symptom severity interviews. Depressive symptoms were also assessed. Manualized treatment involved up to 20 sessions on a weekly basis.
Results:
We found clinically and statistically significant improvements in symptom severity after treatment. At the 3-month and 2-year follow-up, the attained improvements during treatment were retained.
Conclusions:
Despite some methodological limitations, results showed that MCT proved to be a promising psychotherapeutic alternative to the well-established ERP in the treatment of pediatric OCD. Further investigations into the efficacy of MCT are necessary to answer questions as to the working mechanisms underlying therapy for OCD.
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