Parent-based Treatment for Youth With Anxiety and Obsessive-compulsive Disorder: Comparison of Therapist-Led and Therapist Assisted Approaches
Phase: NA
Conditions: Obsessive-Compulsive Disorder in Children, Social Anxiety Disorder of Childhood, Obsessive-Compulsive Disorder in Adolescence, Separation Anxiety, Generalized Anxiety Disorder, Panic Disorder, Panic Attacks, Panic With Agoraphobia
Sponsor: Baylor College of Medicine

Parent-based Treatment for Youth With Anxiety and Obsessive-compulsive 
Disorder 
NCT04922502 
Date Uploaded: 2-22-2024 
Date Last Updated: 12-20-2023 

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%&%&($5-'
)*&#%K+L)
5$a)&N)
/$)&$))P&)#
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Y''(&''&Z
['&Z
	&\](%%[&%'DH
G	*^'H(%G	*^'
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H0%'&!!
H0('&(&1(#*Y(&'
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_G&	&&$YG[D_]G	YGH&(('(%
&%H
H#'%'D'&&^'&(
(H
H0''$%\`&
FH)^'
!H0-''*)0Z'(1$'

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^1*
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H$&]Z(/'$D&%
&$H
H$'$]((&1($$'1(\`

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 !"
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%&'()$''*$+,#'*$
+--	..$+/(0	+0
+102+0%'#'*$+
1'*$+32+--	..%	+
04''5$$+
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F+E'0E100G*
E$)*0+4'4E4'44'$4
'EE50+
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0EE+0$%$+
F00$0-0+$++$+1
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)'*+
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$$'J+E+	0$'
$0$0100+%
J0)E'0+J0E'
'E$0E1%'$
'$$
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%A'3'E'E$'0E
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*$1%J$+(
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'$$'E+$
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1+%)$'0'+
+	+$$$'0E5*'	
'$+E'+$J$+'
%A'0	0+2E'
$''03EE$0E	
$'$E)		E$0$'K,,

'E+$$$'
3*$EH'EI
*+I
+
2$+0$+J
.01%'
0+E''+J+
'00$'+$0
$$(''+$0$.G0/.A
%A'E	E+E$E0$3
+E('$('
E$0$
$'E'J
2+$('0*$*
0$3E0)$'
0'++
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000$04+*'0I
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$+$+0E+++000
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 !"
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/0)	#$1)2%'3.0(	)*+0
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4'.,3'.++$5,30+6'+,
+4#+,00+,,
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,0#$(7$'.,
,$+05$86
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0$+$+0,/#'$.0
0$++9
#$$$'+7
000$7$,+''.
7	,$0'#$'$$
$+$+'04#,3
#.$0$0#$
	,0++3#'3.
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/':'$(	)*+
(	)*+4'+$$+,0
$+	',,;'&		,30+0'
&03'.30'3'
$0,,'$(	)*+'
30'3',,
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(	)*+',03,,',0'.0
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+'.++$',
$5BB"6++'.'3$,43
'30'5'63
'00,+0(	)*4
',
(4	>2	2(	)*@1A/:(	)*+',',3$3
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+0++,+$++
,0$+,,+'.$++
+'00"3'.0(	)*+0
330'
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06350','.630'5'.00'.0
,6>3$530'36'
3(	)*'30'++0
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2+++5<4)3(	)*(	)*6'
,4'30''<4)3
(	)*+,"'.0(	)*'30'

4&*'#0,+5,$64
''&*335
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'3$5;6D
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,35'64+'0++0$
70$'3$0&0
&*',,')',
+'3&		3+5-#6/$,,'.
0EFG4)*00+5)*6HFG44	
))).='0$.00'+<':
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 !"
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9:;<=9:
>?@9?
9::A
@9?B:< ?=9C?:9D< "?=
BBAEB:DDEBEF
GEB:DDE
HIJBJ:F9:K ?9 C9L
EEBDM<M9N9OPM9=
QQLEMP	HR>9A<??=@D
A9DEE	G:DP<	P=
:>9A<??=9::<P
M9=S9DQ:DEEEF
EEAEE "K ?9 CDE 
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ME:E:P:E:<DE
ED:EM=@J
	U:99
::E::
VMA9:AE:N:M<DG:M:=EE
D:9E:MMWE
9<D9MDEMG
DD=E:M
P:	BBDEEEEB
EEMEMDEBBE9HBX:9
<=
G9B9<:D=:
EM<	YHZW	=9BBBE9D
<:M:=@BDDEBBE99
:BED[9DEE:9:
DD
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V:NEO<::DD=N
EN
ZMNE:M:ZNED:E
9:MEDBBE;M:
EEDEXEM9X9M9ME
9:G9ON9DM
::DEJ:::
GG::Pb
:DE:<N=X
:99MD:M
::@9M:b
:9DE:O
XDE<=OG:DEEEP
b
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9:99E:M9E9:AE
:VPV<MD=9M:ME
D:[M:9MDD:9:
:9D:
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.-B'&*?.-.@AIE""J-
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/012345K8L45>0529M410NOM0>
KPQR:3S0M4=L45>052
TB-HEC-I
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CEBAAA?ABGB
A%\A.A@C-BDAB
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%CEABHACEE
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12
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CONSENT FORM 
Parent's Consent to Participate in the Research and Permission to Allow Child to 
Participate in Research
Institutional Review Board for Baylor College of Medicine and Affiliated Hospitals
HIPAA Compliant
H-49809-  PARENT-BASED TREATMENT FOR YOUTH WITH ANXIETY AND 
OBSESSIVE-COMPULSIVE DISORDER
Concise and Focused Presentation
You and your child are invited to take part in a research study looking at the effectiveness of two 
parenting interventions for anxiety and OCD in youth that are based on a cognitive-behavioral approach 
to anxiety and delivered via teletherapy. The first is a therapist-led treatment called Supportive 
Parenting for Anxious Childhood Emotions (SPACE), and the second is a low therapist contact 
bibliotherapy version of SPACE using the book "Breaking Free of Child Anxiety and OCD." Cognitive 
behavioral strategies focus on how your child's thoughts, beliefs, and attitudes affect feelings and 
behavior and teaches coping skills for dealing with different problems. Teletherapy is providing therapy 
through a live connection over the internet (most commonly using video software). 
All families who meet eligibility criteria will receive a parenting intervention based on a 
cognitive-behavioral approach to anxiety. However, the amount of contact you have with your therapist 
will vary depending on the type of treatment. You and your child will be randomized, like a flip of a coin, 
to one of the two interventions: 1) low therapist contact bibliotherapy treatment, where you will receive 
four 45-minute supportive video calls over the 12 weeks of treatment; or 2) therapist-led standard 
SPACE treatment, where you will receive twelve 60-minute sessions with your therapist. If you complete 
the low therapist contact bibliotherapy treatment and it is determined that your child would benefit from 
further treatment, you will be invited to receive up to eight additional therapist-led sessions.
 
If you decide to participate in this study and to allow your child to participate, you will be asked to 
provide your signature at the end of this document. Please take all the time you need to go over the 
information in this document and ask questions as needed. Once you provide written consent for the 
procedures detailed below, you and your child will be asked to participate in a "screening" visit (also 
known as the pre-treatment assessment) to determine your eligibility for the study. If you qualify, your 
participation in the study will last approximately 16-24 weeks (i.e., 12 weeks of treatment, a follow-up 
assessment 4 weeks after treatment ends, and up to 8 weeks of additional treatment if you were in the 
low therapist contact bibliotherapy group). 
 
In order to decide whether or not you wish to participate in this research study, you should know enough 
about the risks and benefits to make an informed decision. Possible risks involved with the study 
include discomfort, frustration, or fatigue from completing questionnaires and clinical interviews that are 
sensitive in nature. As your child begins treatment, they may experience a slight increase in anxiety and 
discomfort. This should be short-lived, and therapy should reduce those effects over the long term. It is 
also possible, although unlikely, that your child's anxiety may worsen during participation. Your child's 
progress will also be regularly monitored, and should your child show worsening symptoms, the PI may 
see fit to withdraw your child from the study and help you seek more appropriate or intensive services. 
Your child may be offered the opportunity for off-protocol treatment, in which case you would be 
responsible for associated fees/costs. 
Potential benefits include better access to care, psychological evaluation, and psychotherapy treatment 
that may reduce symptoms and impairment. 
Approved  from November 30, 2022  to November 29, 2023        Chair Initials: G. H.
Page 1 of 10
Last Amendment:
3/22/2023

CONSENT FORM 
Parent's Consent to Participate in the Research and Permission to Allow Child to 
Participate in Research
Institutional Review Board for Baylor College of Medicine and Affiliated Hospitals
HIPAA Compliant
H-49809-  PARENT-BASED TREATMENT FOR YOUTH WITH ANXIETY AND 
OBSESSIVE-COMPULSIVE DISORDER
You and your child's participation in this study is completely voluntary, and your decision to not 
participate, not allow your child to take part in this study, or to stop participation at any point will not 
affect the care they receive at BCM or at any institution. Alternative treatments are available if you 
choose not to participate in this study, such as seeking care through your insurance (e.g., primary care 
doctors, anxiety or OCD specialists as applicable).
Background
You are invited to take part in a research study. Please read this information and feel free to ask any 
questions before you agree to take part in the study. This document is called an informed consent form. 
The nature of the study, benefits, risks, and other important information about the study are detailed 
below. Because both children and parents can join this study, please take note that the word "you" in 
this consent form refers to both you and your child.
We are asking you to take part in a research study called Parent-Based Treatment for Youth with Anxiety 
and Obsessive-Compulsive Disorder. The person who is in charge of this research study is Dr. Eric 
Storch, Ph.D. This person is called the Principal Investigator. However, other research staff may also be 
involved and can act on behalf of the person in charge.
 
Children between the age of 7 and 17 who experience impairing anxiety and their caregivers may join 
the study.
This research study is funded by Gillson-Longenbaugh Foundation.
A description of this clinical trial will be available on http://www.ClinicalTrials.gov, as required by U.S. 
Law. This Web site will not include information that can identify you. At most, the Web site will include a 
summary of the results. You can search this Web site at any time.
Purpose
This research is being done to compare the effectiveness of two parenting interventions for anxiety and 
OCD in youth that are based on a cognitive-behavioral approach to anxiety. The first is a therapist-led 
treatment called Supportive Parenting for Anxious Childhood Emotions (SPACE), and the second is a 
low therapist contact bibliotherapy version of SPACE using the book "Breaking Free of Child Anxiety 
and OCD."
Procedures
The research will be conducted at the following location(s):  
Baylor College of Medicine.
WHAT WILL HAPPEN IF YOUR CHILD JOINS THIS STUDY? 
If you agree to allow your child to take part in this study, we will ask you and your child to do the following 
things:
 
Once enrolled, both you and your child will be randomized into one of two treatment groups, like a flip of 
Approved  from November 30, 2022  to November 29, 2023        Chair Initials: G. H.
Page 2 of 10
Last Amendment:
3/22/2023

CONSENT FORM 
Parent's Consent to Participate in the Research and Permission to Allow Child to 
Participate in Research
Institutional Review Board for Baylor College of Medicine and Affiliated Hospitals
HIPAA Compliant
H-49809-  PARENT-BASED TREATMENT FOR YOUTH WITH ANXIETY AND 
OBSESSIVE-COMPULSIVE DISORDER
a coin. There is a 50% chance that you and your child will be randomly chosen to receive the 
therapist-led Supportive Parenting of Anxious Childhood Emotions (SPACE) intervention, and a 50% 
chance that you and your child will be assigned to receive the low therapist contact bibliotherapy version 
of SPACE. 
If you are randomized to the therapist-led SPACE group, you will receive the standard SPACE protocol. 
If you are randomized to the low therapist contact bibliotherapy group, treatment will be provided to you 
using 'Breaking Free of Child Anxiety and OCD: A Scientifically Proven Program for Parents', which is a 
parent-oriented book adaptation of the SPACE program for child and adolescent anxiety and/or OCD. 
Treatment will take place over 12-24 weeks through video-conferencing sessions. 
Regardless of condition, your child will receive a parenting intervention based on a cognitive-behavioral 
approach to anxiety and/or OCD via teletherapy. Cognitive behavioral strategies focus on how your 
child's thoughts, beliefs, and attitudes affect feelings and behavior and teaches coping skills for dealing 
with different problems. In these parenting interventions, parents learn to support their children through 
instilling a message of support and encouragement and acknowledging their child's difficult experience 
with anxiety while conveying confidence that they can cope with stressful situations. This is done through 
specifically identifying parental accommodation behaviors they currently use and steadily reducing 
engagement in those behaviors. 
Each week, you will learn tools to increase supportive communication that conveys a message of 
support and encouragement to your child. One core aspect of treatment will be identifying and steadily 
reducing specific accommodation behaviors. For example, parents who routinely speak for their child at 
family gatherings due to their child's social anxiety may gently let their child know that they will no longer 
do so. These exercises serve as parent-led exposures, the key component of therapy for anxiety.
LOW THERAPIST CONTACT BIBLIOTHERAPY GROUP: 
If you and your child are randomized to the low therapist contact bibliotherapy group, you will receive 
four 45-minute supportive video calls with a therapist over the first 12 weeks of treatment. Sessions will 
occur approximately at weeks 1, 4, 6, and 9. You will receive a copy of the book "Breaking Free of Child 
Anxiety and OCD" to use at home and in-session with the therapist. During each of the four 
video-conferencing sessions, therapists will serve to provide you with encouragement and support as 
you work through the program independently with your child. 
One month after the twelfth week of treatment, participants in the low therapist contact bibliotherapy 
SPACE group will be assessed to determine whether their children have responded to the treatment. If 
it is determined that your child would benefit from further treatment, you will be invited to receive up to 8 
additional weekly sessions of therapist-led standard SPACE treatment. 
STANDARD SPACE GROUP:
If you and your child are randomized to the standard SPACE group, you will receive twelve 60-minute 
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3/22/2023

CONSENT FORM 
Parent's Consent to Participate in the Research and Permission to Allow Child to 
Participate in Research
Institutional Review Board for Baylor College of Medicine and Affiliated Hospitals
HIPAA Compliant
H-49809-  PARENT-BASED TREATMENT FOR YOUTH WITH ANXIETY AND 
OBSESSIVE-COMPULSIVE DISORDER
supportive video calls with a therapist over the 12 weeks of treatment. Sessions will occur 
approximately weekly. During each of the twelve videoconferencing sessions, therapists will guide you 
through the implementation of the program, including explaining materials, discussing and practicing 
supportive communication, identifying accommodation behaviors, and developing weekly goals related 
to reducing accommodation. Additional treatment beyond the initial 12 weeks will not be available for 
participants in the standard SPACE group. 
ASSESSMENTS:
In addition to treatment, you and your child will participate in a total of 3-4 assessment visits. These 
visits will take place as follows: (1) Pre-treatment assessment (approximately 3 hours); (2) 
Post-treatment assessment (after the 12 weeks of treatment; approximately 2-3 hours); (3) one-month 
follow-up assessment (1 month after your post-assessment; about 2-3 hours). If you are in the low 
therapist contact bibliotherapy group and receive the additional therapist-led sessions, you will 
participate in a fourth assessment after your last session. 
Follow-up assessments will be completed through Zoom video conferencing or over the phone. These 
assessments will be administered to you by an independent evaluator (IE) and include measures 
assessing mental health problems or disorders, mood, functioning, related impairment, etc. The IE is an 
experienced clinician, a trained professional, or an advanced graduate trainee (supervised by an 
experienced clinician). 
All treatment sessions and assessments will be audio- and/or videotaped to make sure that therapists 
and IEs are providing a high quality of care. These audio files are for research purposes only and will 
only be shared with research staff affiliated with this project. You or your child will generally not have 
access to these files. However, if files are necessary to your care, they will be shared with you or your 
physician. 
At the start of the study, we will assign a special number or code to your and your child's study data, 
which will not contain any personal information (e.g., your name, your child's name, your child's date of 
birth) that could identify you or them. The document that links the coded information to their identifiers 
will be stored separately and will only be accessible to the investigators in this study. All data being 
collected will be stored in a locked file cabinet, and only the PI or a member of the study staff will be 
able to access them. 
YOUR CHILD SHOULD NOT PARTICIPATE IN THIS STUDY IF ANY OF THE FOLLOWING APPLY: 
[1] You child is receiving psychotherapy for anxiety, involving exposure therapy in at least half of the 
sessions, at the same time as the study treatment.
[2] Your child has started or changed an antidepressant medication within 4 weeks before study 
enrollment or a stimulant or benzodiazepine medication 2 weeks before study enrollment. 
Approved  from November 30, 2022  to November 29, 2023        Chair Initials: G. H.
Page 4 of 10
Last Amendment:
3/22/2023

CONSENT FORM 
Parent's Consent to Participate in the Research and Permission to Allow Child to 
Participate in Research
Institutional Review Board for Baylor College of Medicine and Affiliated Hospitals
HIPAA Compliant
H-49809-  PARENT-BASED TREATMENT FOR YOUTH WITH ANXIETY AND 
OBSESSIVE-COMPULSIVE DISORDER
[3] Your child has severe current suicidal/homicidal ideation and/or self-injury requiring medical 
intervention. This is to ensure that we are providing the appropriate level of care for youth. 
FUTURE CONTACT
Research is always an ongoing process and new questions arise every day. That is why we are asking 
families in this study if they would be willing to be contacted in the future about research related to this or 
other studies. If you do not wish to be contacted, in no way will it affect your involvement in this study, in 
other studies, or in any other services you currently receive or may receive in the future at BCM (or other 
institutions). 
Please review the two statements below and then INITIAL & DATE next to the statement that is right for 
you. 
___________ /___________ YES, I agree to be contacted in the future about research related to this 
or other studies. 
___________ / ___________ NO, I do not agree to be contacted in the future about research related to 
this or other studies.
Clinically Relevant Research Results
The results generated from this research study are not expected to have any clinical relevance to you.
Sharing and Future Research Studies with Identifiable Private Information
Information that identifies you may be removed from your identifiable private information collected as 
part of this research, and after such removal, your information may be used for future research studies 
or distributed to another investigator for future research studies without additional consent/authorization 
from you.
Authorization to Use or Disclose (Release) Health Information that Identifies You for a Research Study
If you sign this document, you give permission to people who give medical care and ensure quality from 
Baylor College of Medicine  to use or disclose (release) your health information that identifies you for 
the research study described in this document.
The health information that we may use or disclose (release) for this research includes:
     •  Information from health records such as diagnoses, progress notes, medications, lab or radiology 
findings, etc.
     •  Specific information concerning psychiatry notes
     •  Demographic information (name, D.O.B., age, gender, race, etc.)
     •  Photographs, videotapes, and/or audiotapes of you
Research related health information
Approved  from November 30, 2022  to November 29, 2023        Chair Initials: G. H.
Page 5 of 10
Last Amendment:
3/22/2023

CONSENT FORM 
Parent's Consent to Participate in the Research and Permission to Allow Child to 
Participate in Research
Institutional Review Board for Baylor College of Medicine and Affiliated Hospitals
HIPAA Compliant
H-49809-  PARENT-BASED TREATMENT FOR YOUTH WITH ANXIETY AND 
OBSESSIVE-COMPULSIVE DISORDER
The health information listed above may be used by and or disclosed (released) to researchers, their 
staff and their collaborators on this research project, the Institutional Review Board, Baylor College of 
Medicine, and GILLSON LONGENBAUGH FOUNDATION and their representatives.
Use or Disclosure Required by Law
Your health information will be used or disclosed when required by law.
Your health information may be shared with a public health authority that is authorized by law to collect or 
receive such information for the purpose of preventing or controlling disease, injury, or disability and 
conducting public health surveillance, investigations or interventions.
Baylor College of Medicine is required by law to protect your health information. By signing this 
document, you authorize Baylor College of Medicine to use and/or disclose (release) your health 
information for this research. Those persons who receive your health information may not be required by 
Federal privacy laws (such as the Privacy rule) to protect it and may share your information with others 
without your permission, if permitted by laws governing them.
Please note that the research involves treatment.  You do not have to sign this Authorization, but if you 
do not, you may not receive research-related treatment.  To maintain the integrity of this research study, 
you generally will not have access to your personal health information related to this research until the 
study is complete. However, your health information that is necessary to your care will be provided to 
you or your physician. At the conclusion of the research and at your request, you generally will have 
access to your health information that Baylor College of Medicine maintain in a designated record set, 
which means a set of data that includes medical information or billing records used in whole or in part 
by your doctors or other health care providers at Baylor College of Medicine to make decisions about 
individuals. Access to your health information in a designated record set is described in the Notice of 
Privacy Practices provided to you by representatives of the specific institution where you are being 
enrolled into this research study which are: Baylor College of Medicine.
Please note that you may change your mind and revoke (take back) this Authorization at any time. Even 
if you revoke this Authorization, researchers, their staff and their collaborators on this research project, 
the Institutional Review Board, GILLSON LONGENBAUGH FOUNDATION and their representatives, 
regulatory agencies such as the U.S. Department of Health and Human Services, Baylor College of 
Medicine may still use or disclose health information they already have obtained about you as 
necessary to maintain the integrity or reliability of the current research.  If you revoke this Authorization, 
you may no longer be allowed to participate in the research described in this Authorization .
To revoke this Authorization, you must write to: Eric Storch, Ph.D., Menninger Department of Psychiatry 
and Behavioral Sciences 1977 Butler Blvd, Suite 4-197 Houston, TX 77030
This authorization does not have an expiration date. If all information that does or can identify you is 
Approved  from November 30, 2022  to November 29, 2023        Chair Initials: G. H.
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Last Amendment:
3/22/2023

CONSENT FORM 
Parent's Consent to Participate in the Research and Permission to Allow Child to 
Participate in Research
Institutional Review Board for Baylor College of Medicine and Affiliated Hospitals
HIPAA Compliant
H-49809-  PARENT-BASED TREATMENT FOR YOUTH WITH ANXIETY AND 
OBSESSIVE-COMPULSIVE DISORDER
removed from your health information, the remaining information will no longer be subject to this 
authorization and may be used or disclosed for other purposes.
No publication or public presentation about the research described above will reveal your identity 
without another authorization from you.
Researchers will take appropriate steps to protect any information they will collect about your child. 
However, there is a slight risk that information about him or her could be revealed inappropriately or 
accidentally. Similarly, your child's assessments and therapy sessions may be audiotaped or 
videotaped. Only the PI and the research team will have access to these audio and video files and they 
are for quality assurance and research purposes. You will not be able to review the audio and video 
files, which will be kept on BCM's secure network drive. Although they will be stored securely, there is 
some risk that the files could be redisclosed.
Other possible risks to you or your child child may include the psychiatric evaluation and administration 
of rating scales and participation in parenting interventions for anxiety and OCD that are based in 
cognitive-behavioral strategies.The main risk of the psychiatric evaluation and administering of rating 
scales is that you and your child may experience mild discomfort due to the discussion of subjectively 
difficult topics. However, our experience shows that most people appreciate the opportunity to discuss 
their experiences with a trained clinician. The length of time required for the interviews and 
questionnaires is a possible discomfort. You and your child will be given as many breaks as needed 
during that time. You you and your child also do not have to answer any questions if you or they do not 
want to.
As your child begins treatment, they may experience a slight increase in anxiety and discomfort. This 
should be short-lived and therapy should reduce those effects over the long term. Your child may also 
experience distress during exposure exercises. It is also possible, although unlikely, that your child's 
anxiety may worsen during participation. In the instance that your child's symptoms worsen, they may be 
offered the opportunity for off-protocol treatment, in which case you will be responsible for associated 
fees/costs.
Participation in more than one research study or project may further increase the risks to your child. If 
your child is already enrolled in another research study, please inform the PI or the person reviewing this 
consent with you before enrolling your child in this or any other research study or project. 
If you or your child wish to discuss the information above or any discomforts you may experience, 
please ask questions now or call Dr. Storch at 713-798-3579.
Potential Risks and Discomforts
Study staff will update you in a timely way on any new information that may affect your decision to stay in 
the study.  There is a small risk for the loss of confidentiality. However, the study personnel will make 
every effort to minimize these risks.
Approved  from November 30, 2022  to November 29, 2023        Chair Initials: G. H.
Page 7 of 10
Last Amendment:
3/22/2023

CONSENT FORM 
Parent's Consent to Participate in the Research and Permission to Allow Child to 
Participate in Research
Institutional Review Board for Baylor College of Medicine and Affiliated Hospitals
HIPAA Compliant
H-49809-  PARENT-BASED TREATMENT FOR YOUTH WITH ANXIETY AND 
OBSESSIVE-COMPULSIVE DISORDER
Potential Benefits
The benefits of participating in this study may be: your child experiencing improvements in both quality 
of life and psychosocial functioning, as well as reductions in symptoms presentation and related 
impairment.  However, you may receive no benefit from participating.
Alternatives
The following alternative procedures or treatments are available if you choose not to participate in this 
study: Participants will be free to seek care through their insurance (e.g., primary care doctors, anxiety 
or OCD specialists as applicable).
Investigator Withdrawal of Subject from a Study
The investigator or sponsor may decide to stop you from taking part in this study at any time. You could 
be removed from the study for reasons related only to you (for example, if you move to another state, or 
if you are unable to keep appointments) or because the entire study is stopped. The sponsor, 
investigator, or Institutional Review Board may stop the study at any time.
Your child may be removed from the study without your consent if:
- Your child does not qualify to be in the study because he or she does not meet the study requirements . 
Ask the PI if you would like more information about these requirements.
- Your child needs a medical treatment or a higher level of care not allowed in this study (e.g., 
suicidality).
- The investigator decides that continuing the study would be harmful to your child.
- Study treatments have a bad effect on your child.
- Your child is unable to keep appointments as directed (you do not attend or are not responsive to 
scheduling assessments or sessions if you cancel within 24 hours or no-show one or more 
assessments or sessions. The investigator may determine that missed or canceled sessions may count 
towards the sessions provided.
- The study is canceled and/or other administrative reasons.
Subject Costs and Payments
You will not be asked to pay any costs related to this research.
You will not be paid for taking part in this study.
Subject's Rights
Your signature on this consent form means that you have received the information about this study and 
that you agree to volunteer for this research study.
Approved  from November 30, 2022  to November 29, 2023        Chair Initials: G. H.
Page 8 of 10
Last Amendment:
3/22/2023

CONSENT FORM 
Parent's Consent to Participate in the Research and Permission to Allow Child to 
Participate in Research
Institutional Review Board for Baylor College of Medicine and Affiliated Hospitals
HIPAA Compliant
H-49809-  PARENT-BASED TREATMENT FOR YOUTH WITH ANXIETY AND 
OBSESSIVE-COMPULSIVE DISORDER
You will be given a copy of this signed form to keep.  You are not giving up any of your rights by signing 
this form.  Even after you have signed this form, you may change your mind at any time. Please contact 
the study staff if you decide to stop taking part in this study.
If you choose not to take part in the research or if you decide to stop taking part later, your benefits and 
services will stay the same as before this study was discussed with you.  You will not lose these 
benefits, services, or rights.
The investigator, ERIC STORCH, and/or someone he/she appoints in his/her place will try to answer all 
of your questions. If you have questions or concerns at any time, or if you need  to report an injury related 
to the research, you may speak with a member of the study staff: ERIC STORCH at 713-798-3579 
during the day. You will receive a return call within two business days. This is not an emergency number. 
If there is an emergency, please call 911 or go to the nearest emergency room.
Members of the Institutional Review Board for Baylor College of Medicine and Affiliated Hospitals (IRB) 
can also answer your questions and concerns about your rights as a research subject. The IRB office 
number is (713) 798-6970. Call the IRB office if you would like to speak to a person independent of the 
investigator and research staff for complaints about the research, if you cannot reach the research staff, 
or if you wish to talk to someone other than the research staff.
If your child is the one invited to take part in this study you are signing to give your permission. Each 
child may agree to take part in a study at his or her own level of understanding. When you sign this you 
also note that your child understands and agrees to take part in this study according to his or her 
understanding.
Please print your child's name here __________________________
Approved  from November 30, 2022  to November 29, 2023        Chair Initials: G. H.
Page 9 of 10
Last Amendment:
3/22/2023

CONSENT FORM 
Parent's Consent to Participate in the Research and Permission to Allow Child to 
Participate in Research
Institutional Review Board for Baylor College of Medicine and Affiliated Hospitals
HIPAA Compliant
H-49809-  PARENT-BASED TREATMENT FOR YOUTH WITH ANXIETY AND 
OBSESSIVE-COMPULSIVE DISORDER
Signing this consent form indicates that you have read this consent form (or have had it read to you), 
that your questions have been answered to your satisfaction, and that you voluntarily agree to 
participate in this research study.  You will receive a copy of this signed consent form.
Subject
Date
Legally Authorized Representative
Parent or Guardian
Date
Investigator or Designee Obtaining Consent
Date
Witness (if applicable)
Translator (if applicable)
Date
Date
Approved  from November 30, 2022  to November 29, 2023        Chair Initials: G. H.
Page 10 of 10
Last Amendment:
3/22/2023