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Effects of Treatment Setting on Outcomes of Flexibly-Dosed Intensive Cognitive Behavioral Therapy for Pediatric OCD:

Robert R Selles1,2, Zainab Naqqash1,2, John R Best1,2,3

  • 1British Columbia Children's Hospital Research Institute, Vancouver, BC, Canada.

Frontiers in Psychiatry
|June 3, 2021
PubMed

Insights

Intensive cognitive-behavioral therapy (CBT) effectively treats pediatric obsessive-compulsive disorder (OCD). Home-based treatment showed minor benefits for maintaining gains and patient comfort, though outcomes were similar to clinic-based care.

Area of Science:

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

Background:

  • Optimizing outcomes for pediatric cognitive-behavioral therapy (CBT) is crucial.
  • Individualized treatment approaches are needed to enhance efficacy.
  • Pediatric obsessive-compulsive disorder (OCD) requires effective therapeutic interventions.

Purpose of the Study:

  • To compare the efficacy of intensive CBT delivered in a hospital clinic versus a home-based setting for youth with OCD.
  • To assess treatment satisfaction and utilization patterns of flexible-dose CBT.
  • To evaluate OCD-related and secondary outcomes at multiple time points.

Main Methods:

  • Randomized controlled trial comparing hospital-based intensive CBT (n=14) with home-based intensive CBT (n=12).
  • Both groups received 3 initial 3-hour sessions, with optional additional sessions (Phase II).
  • Outcomes including OCD severity, impairment, quality of life, and comorbid symptoms were assessed post-treatment and at 1- and 6-month follow-ups.

Main Results:

  • High family satisfaction reported for both treatment settings.
  • Significant improvements observed in OCD-related outcomes and moderate benefits in secondary domains.
  • No statistically significant differences in primary outcomes between settings; home-based treatment showed slight advantages in gain maintenance and comfort.

Conclusions:

  • Intensive CBT is an effective treatment for pediatric OCD, with flexible dosing based on patient needs.
  • Home-based CBT offers comparable efficacy to clinic-based treatment, with potential advantages in specific areas.
  • Further research into tailored delivery methods for pediatric OCD treatment is warranted.

Keywords:
exposure and response preventionfamily treatmenthome-based treatmentstepped caretreatment trial

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