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BACKGROUND: Reviews and practice guidelines for paediatric obsessive-compulsive disorder (OCD) recommend cognitive-behaviour therapy (CBT) as the psychological treatment of choice, but note that it has not been sufficiently evaluated for children and adolescents and that more randomized controlled trials are needed. The aim of this trial was to evaluate effectiveness and optimal delivery of CBT, emphasizing cognitive interventions. METHODS: A total of 96 children and adolescents with OCD were randomly allocated to the three conditions each of approximately 12 weeks duration: full CBT (average therapist contact: 12 sessions) and brief CBT (average contact: 5 sessions, with use of therapist-guided workbooks), and wait-list/delayed treatment. The primary outcome measure was the child version of the semi-structured interviewer-based Yale-Brown Obsessive Compulsive Scale. CLINICAL TRIAL REGISTRATION: http://www.controlled-trials.com/ISRCTN/; unique identifier: ISRCTN29092580. RESULTS: There was statistically significant symptomatic improvement in both treatment groups compared with the wait-list group, with no significant differences in outcomes between the two treatment groups. Controlled treatment effect sizes in intention-to-treat analyses were 2.2 for full CBT and 1.6 for brief CBT. Improvements were maintained at follow-up an average of 14 weeks later. CONCLUSIONS: The findings demonstrate the benefits of CBT emphasizing cognitive interventions for children and adolescents with OCD and suggest that relatively lower therapist intensity delivery with use of therapist-guided workbooks is an efficient mode of delivery.

Original publication

DOI

10.1111/j.1469-7610.2011.02419.x

Type

Journal article

Journal

J Child Psychol Psychiatry

Publication Date

12/2011

Volume

52

Pages

1269 - 1278

Keywords

Adolescent, Child, Cognitive Behavioral Therapy, Female, Humans, Male, Obsessive-Compulsive Disorder, Time Factors, Treatment Outcome, Waiting Lists