Behavior Therapy for Children and Adolescents With Obsessive-Compulsive Disorder (OCD)
Condition: Obsessive-Compulsive Disorder
MeSH terms: Compulsive Personality Disorder; Obsessive-Compulsive Disorder
Study type: Interventional
Phase: Phase 3

Summary: 
      The purpose of this study is to evaluate a behavioral treatment program for children and
      adolescents with OCD and their families. Exposure and Response Prevention (ERP) behavior
      therapy, in which the patient is gradually exposed to the object or situation that causes
      anxiety and is taught to refrain from responding in a compulsive manner, is combined with
      family counseling (Family Treatment Program). This treatment will be compared to Relaxation
      Training (RT).

      OCD is a long-term, often disabling disorder that can cause significant family disruption.
      ERP is a promising treatment for children with OCD, and it is thought that family
      participation (through the Family Treatment Program) may be a helpful addition. RT is a
      common treatment for anxiety.

      Patients are assigned randomly (like tossing a coin) to receive either the ERP/Family
      Treatment Program or RT. Both treatments will be delivered over 12 90-minute outpatient
      sessions to youngsters and their families. All participants (patients and family members)
      will be assessed for treatment response each month during treatment, after treatment is
      finished, and then at 2 follow-up visits over the following 6 months.

      A child/adolescent may be eligible for this study if he/she:

      Has obsessive-compulsive disorder (OCD), is medication-free, and is 8 to 17 years old.
    

Detailed description: 
      To evaluate a standardized multicomponent cognitive behavioral treatment program for child
      and adolescent obsessive-compulsive disorder (OCD). The treatment program consists of
      individual Exposure and Response Prevention (ERP) for the OCD child plus a concurrent family
      intervention designed to reduce OCD-related family conflict, facilitate family disengagement
      from the affected child's OCD behavior, and rebuild normal family interaction patterns. The
      ERP/Family Treatment Program is compared with Relaxation Training (RT).

      OCD is a chronic, often disabling disorder in childhood that has been associated with
      increased rates of parental psychopathology and significant disruptions in family
      relationships and functioning. Preliminary studies suggest that ERP is an effective treatment
      for children with OCD although no controlled trials to this effect have been published. RT
      was selected as the comparison treatment because of its credibility as an anxiety treatment
      and familiarity to potential subjects. RT has been used as a comparison condition for at
      least 2 randomized controlled ERP trials for adult OCD and shown to be ineffective in
      treating this disorder. Although it has long been hypothesized that family participation in
      treatment may be helpful, this is the first controlled study incorporating a systematic
      manualized family treatment component.

      Participants are randomly assigned to receive either the combined ERP/Family Treatment
      Program (n=56) or RT (n=24). Both treatments are delivered over 12 90-minute outpatient
      sessions according to detailed treatment manuals.Youth and families undergo comprehensive and
      systematic, including behavioral, assessments by blind clinical evaluators at baseline,
      monthly during treatment, post-treatment and 2 follow-up evaluations over 6 months. Treatment
      outcome is examined in multimodal fashion and across multiple functional domains with a
      special emphasis on family contextual variables. The impact of baseline functioning,
      including family context, and initial change over time on treatment outcome is also
      systematically evaluated.
    

Intervention name(s): Exposure and Response Prevention; Family Treatment Program; Relaxation Training; Behavior therapy; Family Counseling
Intervention type(s): Behavioral; Behavioral; Behavioral; Behavioral; Behavioral
Allocation: Randomized
Primary purpose: Treatment
Keywords: Adolescence; Child; Comparative Study; Family; Female; Human; Male; Obsessive-Compulsive Disorder; Relaxation Techniques; Obsessive-Compulsive Disorder -- *therapy