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. 2021 May 17:12:669494.
doi: 10.3389/fpsyt.2021.669494. eCollection 2021.

Effects of Treatment Setting on Outcomes of Flexibly-Dosed Intensive Cognitive Behavioral Therapy for Pediatric OCD: A Randomized Controlled Pilot Trial

Robert R Selles  1   2 , Zainab Naqqash  1   2 , John R Best  1   2   3 , Diana Franco-Yamin  1   2 , Serene T Qiu  4 , Jessica S Ferreira  5 , Xiaolei Deng  4 , Dagmar Kr Hannesdottir  6 , Carla Oberth  5 , Laura Belschner  5 , Juliana Negreiros  1 , Lara J Farrell  7 , S Evelyn Stewart  1   2   8
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Effects of Treatment Setting on Outcomes of Flexibly-Dosed Intensive Cognitive Behavioral Therapy for Pediatric OCD: A Randomized Controlled Pilot Trial

Robert R Selles et al. Front Psychiatry. .

Abstract

Introduction: Optimizing individual outcomes of cognitive-behavioral therapy (CBT) remains a priority. Methods: Youth were randomized to receive intensive CBT at a hospital clinic (n = 14) or within their home (n = 12). Youth completed 3 × 3 h sessions (Phase I) and up to four additional 3-h sessions as desired/needed (Phase II). An independent evaluator assessed youth after Phase I, Phase II (when applicable), and at 1- and 6-months post-treatment. A range of OCD-related (e.g., severity, impairment) and secondary (e.g., quality of life, comorbid symptoms) outcomes were assessed. Results: Families' satisfaction with the treatment program was high. Of study completers (n = 22), five youth (23%) utilized no Phase II sessions and 9 (41%) utilized all four (Median Phase II sessions: 2.5). Large improvements in OCD-related outcomes and small-to-moderate benefits across secondary domains were observed. Statistically-significant differences in primary outcomes were not observed between settings; however, minor benefits for home-based treatment were observed (e.g., maintenance of gains, youth comfort with treatment). Discussion: Intensive CBT is an efficacious treatment for pediatric OCD. Families opted for differing doses based on their needs. Home-based treatment, while not substantially superior to hospital care, may offer some value, particularly when desired/relevant. Clinical Trial Registration: www.ClinicalTrials.gov; https://clinicaltrials.gov/ct2/show/NCT03672565, identifier: NCT03672565.

Keywords: exposure and response prevention; family treatment; home-based treatment; stepped care; treatment trial.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Flow chart of participants through study procedures.
Figure 2
Figure 2
Change in OCD-related outcomes across timepoints and between groups. See Table 1 for a list of all measure abbreviations.
Figure 3
Figure 3
Change in secondary outcomes across timepoints and between groups. See Table 1 for a list of all measure abbreviations.
See this image and copyright information in PMC

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