Mindfulness for Parents of OCD-affected Children

Study Overview
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Brief Summary
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The purpose of this study is to investigate the role of a mindfulness-based skills training program for parents of children with obsessive compulsive disorder (OCD). The investigators will explore if parents involved in this group experience any change in their levels of stress, feelings of being an effective parent and family relationships compared to a waiting list control period. The investigators will look at how the family manages OCD in their lives. In particular, if mindfulness skills training will help increase the parents ability to tolerate distress in their child secondary to OCD and as such reduce the family accommodation of OCD. As family accommodation is an important negative prognostic predictor for children with OCD, changes in OCD symptom severity and functional impact in these child will also be measured.

Detailed Description
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Obsessive-compulsive disorder (OCD) is a debilitating psychiatric illness that frequently begins in childhood. It is characterized by obsessions and/or compulsions that are distressing, time consuming and significantly impairing. OCD is distinct in the extent to which it disrupts family functioning, in that there is intense parental pressure to become involved in rituals and to change home environments and schedules to avoid triggers, thus accommodating the OCD. It is also well known that OCD severity tends to worsen in the context of stressful environments and situations. While effective treatment approaches for pediatric OCD have been identified, partial response and treatment refusal are all too common, leading to chronicity of both the illness itself and of its deleterious familial effects. The investigators plan to study a novel approach to help manage the stress of parenting a child with OCD, thus facilitating more effective resistance to OCD family accommodation and supporting the child in fighting this difficult illness. The investigators will explore the role of group-based mindfulness-based skills training (P-MBST) in supporting parents of OCD-affected youth, in particular investigating the possibility that increased distress tolerance as a result of mindfulness practice may help parents reduce OCD accommodation.

Official Title
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A Trial of Mindfulness-Based Skills Training Groups Versus a Waiting List Control Period for Parents of Obsessive-Compulsive Disorder (OCD)-Affected Youth

Conditions
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Obsessive-Compulsive Disorder

Intervention / Treatment
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* Behavioral: Mindfulness-Based Skills Training (MBST)
* Other: Waitlist control (WLC)


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Parents (or step-parents or legal guardians) with care-giving role for an OCD-affected youth from our clinic Participants must be able to converse in English Participants willing to attend 8 sessions of a weekly 1.5 hour group, in addition to complete questionnaires at multiple time points during the group and waiting list period. Exclusion Criteria: Parents who have previously participated in mindfulness skills training. Parents with active psychosis, mania, mental retardation, autism or current substance misuse. Parents unwilling to provide consent. Families who are not attending our program's group-family Cognitive-Behavioral Therapy treatment concurrently.

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Non-Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: Waitlist control (WLC)<br>Observation surveys over an 8-week period. | Behavioral: Mindfulness-Based Skills Training (MBST)<br>* 8-week mindfulness skills training sessions based on Mindfulness-Based Cognitive Therapy (MBCT) program by Zindel Segal, Mark Williams and John Teasdale<br>|
| Active Comparator: Mindfulness-Based Skills Training (MBST)<br>Attendance at weekly 1.5-hour group sessions and surveys over an 8-week period. | Other: Waitlist control (WLC)<br>* Observation surveys at baseline, mid-point and end-point of an 8-week period<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change in parental stress levels compared to waiting list control (WLC). | Parental stress levels is measured using the Parenting Stress Index - Short Form (PSI-SF) for parents with children under 13 years of age and the Stress Index for Parents of Adolescents - Short Form (SIPA-SF) for parents with children who are 13 years and older. The PSI-SF and SIPA-SF are both measures of parental stress, but with a difference in age cut-off. | Baseline (first week of P-MBST), Mid-treatment (fifth week of P-MBST), Post-treatment (within one week of completing 8-week P-MBST sessions) and follow-up (one month following P-MBST) | 
| Change in ability to tolerate OCD-related distress compared to waiting list control (WLC). | The ability to tolerate OCD-related distress is measured using the Parental Tolerance of Child Distress (PT-OCD) scale. | Baseline (first week of P-MBST), Mid-treatment (fifth week of P-MBST), Post-treatment (within one week of completing 8-week P-MBST sessions) and follow-up (one month following P-MBST) | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change in ability to resist family accommodation of the child's OCD symptoms compared to waiting list control (WLC). | Family accommodation is measured by the Family Accommodation Scale (FAS) | Baseline (first week of P-MBST), and Post-treatment (within one week of completing 8-week P-MBST sessions). | 
| Change in family functioning compared to the waiting list control (WLC). | Family functioning in relation to the impact of OCD on the family is measured by the OCD Family Functioning Scale (OFF). | Baseline (first week of P-MBST), and Post-treatment (within one week of completing 8-week P-MBST sessions). | 
| Change in OCD severity compared to waiting list control (WLC). | OCD symptom severity is measured with the Children's Yale Brown Obsessive-Compulsive Scale (CY-BOCS), rated by the parent. | Baseline (first week of P-MBST), and Post-treatment (within one week of completing 8-week P-MBST sessions). | 
| Change in OCD-associated coercive and disruptive symptoms compared to waiting list control (WLC). | Coercive and disruptive behaviours is measured using the Coercive and Disruptive behaviours in Pediatric OCD (CD-POC) scale. | Baseline (first week of P-MBST), and Post-treatment (within one week of completing 8-week P-MBST sessions). | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Mindfulness training, Parents and families, Pediatric OCD