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Family-based exposure and response prevention therapy for preschool-aged children with obsessive-compulsive disorder:

Adam B Lewin1, Jennifer M Park2, Anna M Jones2

  • 1Department of Pediatrics, University of South Florida, USA; Department of Psychology, University of South Florida, USA; Department of Psychiatry & Behavioral Neurosciences, University of South Florida, USA.

Behaviour Research and Therapy
|March 25, 2014
PubMed

Insights

Family-based exposure/response prevention therapy (E/RP) significantly reduced obsessive-compulsive disorder (OCD) symptoms in very young children. This developmentally tailored E/RP approach was well-tolerated and effective, showing lasting results.

Area of Science:

  • Child and Adolescent Psychiatry
  • Behavioral Therapy
  • Pediatric Mental Health

Background:

  • Early-onset obsessive-compulsive disorder (OCD) in very young children presents unique treatment challenges.
  • Limited research exists on the efficacy of specific therapies for this age group.

Purpose of the Study:

  • To assess the feasibility, acceptability, and preliminary efficacy of family-based exposure/response prevention therapy (E/RP).
  • To compare E/RP with treatment as usual (TAU) in children aged 3-8 years with early-onset OCD.

Main Methods:

  • A randomized controlled trial involving 31 children (mean age 5.8 years) diagnosed with OCD.
  • Participants were assigned to either family-based E/RP (12 sessions over 6 weeks) or TAU.
  • Outcomes were measured using the Children's Yale-Brown Obsessive Compulsive Scale and Clinical Global Impression at baseline, post-treatment, and 1- and 3-month follow-ups.

Main Results:

  • A significant group effect favored E/RP over TAU (d = 1.69).
  • Treatment responders were 65% in the E/RP group versus 7% in the TAU group.
  • Symptom remission was achieved by 35.2% of the E/RP group, with no remission in the TAU group. Gains were maintained at 3 months.

Conclusions:

  • Developmentally tailored E/RP is effective and well-tolerated for reducing OCD symptoms in children as young as 3 years.
  • Key adaptations include extensive parent involvement, addressing family accommodation, and frequent sessions.
  • Family-based E/RP offers a promising treatment for early-onset pediatric OCD.
Abstract

Keywords:
AccommodationCognitive therapyExposure-response preventionOCDPreschoolVery young children

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