Behavioral Group Treatment for Obsessive-Compulsive Disorder in Adolescence: A Pilot Study

Abstract

This pilot study is a preliminary evaluation of the effectiveness of a cognitive-behavioral outpatient group treatment (CBT) protocol for adolescents with Obsessive-Compulsive Disorder (OCD). Seven adolescents were treated in a 10-session group CBT program with weekly 2-hour sessions. The treatment protocol was an adaptation of approaches with established effectiveness and emphasized three main components: externalizing the OCD by cultivating mindful detachment; exposure and response prevention (ERP); and refocusing on alternative, constructive behaviors following exposure. An occupational therapy component played a significant role in designing creative exposure and refocusing challenges. Self-report measures at pre, post, and 12-month follow-up suggested clinical improvements for 5 of the 7 patients, thus partially supporting a group treatment format for adolescents with mild to moderate OCD.

Evidence Base Update for Psychosocial Treatments for Pediatric Obsessive-Compulsive Disorder

“…The specific emphasis of the CBT (i.e., exposure versus cognitive strategies) is noted when describing the studies below. The format was divided based on the criteria used by Barrett et al (2008) and included individual CBT (Bjorgvinsson et al, 2008; Bolton & Perrin, 2008; Bolton et al, 2011; Franklin et al, 2011; Storch, Murphy et al, 2010; Whiteside & Jacobsen, 2010; Williams et al, 2010) family-focused individual CBT (Freeman et al, 2008; Ginsburg, Burstein, Becker, & Drake, 2011; Merlo et al, 2010; Piacentini et al, 2011; Storch, Lehmkuhl et al, 2010), non-family focused group CBT (Olino et al, 2011; Sochting & Third, 2009), and family-focused group CBT (Farrell, Waters, Milliner, & Ollendick, in press; Farrell, Schlup, & Boschen, 2010). Family-focused CBT treatments had to consistently rely on parent (and sometimes sibling) involvement throughout treatment, rather than just including psychoeducation or a limited number of parent sessions.…”

“…Sochting & Third (2009) treated 7 adolescents using 10 2-hour sessions of group CBT. Outcome was assessed by the same individual who facilitated the group.…”

“…The study by Olino et al (2011) also lacks controlled data but similarly demonstrated significant reductions in OCD symptoms from pre- to post-treatment. Another recent study by Sochting & Third (2009) also examined non-family-focused group CBT for OCD, but is limited by a very small sample size, lack of control group, and significant results at follow-up but not at the end of acute treatment. Taken together, these studies indicate that non-family focused group CBT is a possibly efficacious treatment at this time.…”

Stigma in Obsessive Compulsive Disorder

“…In many countries, support groups have been established for OCD individuals and their families. Bringing together individuals who live in similar conditions allows a group to become less isolated from society [106]. Children learn from their peers.…”

“…Web-based systems can communicate with social media [103] or virtual-based systems can be effective. The direction of occupational therapists to social support groups and peer support groups is the occupational therapy interventions that promote social integration of clients and thus reduce stigma [79,106].…”