Comparing the Effectiveness of Two Family-Based Therapies in Treating Young Children With Obsessive-Compulsive Disorder

Obsessive-compulsive disorder (OCD) is a type of anxiety disorder that affects approximately
1 in 200 children. Although feelings of anxiety, fear, and uncertainty are a normal part of
life and growing up, for some children these feelings and emotions become chronic,
relentless, and progressively worse if left untreated. OCD is characterized by obsessions,
or repeated unsettling thoughts, causing a person to perform repeated actions called
compulsions. Children are typically not diagnosed with OCD until they are between the ages
of 8 and 12, leaving many young children undiagnosed. Additionally, no psychotherapy
treatments have been designed for young children who are under the age of 8 and have OCD.
The purpose of this study is to develop and evaluate a family-based treatment program for
children, ages 5 to 8, who have been diagnosed with OCD.

Participants in this open-label study will be randomly assigned to receive either cognitive
behavior therapy (CBT) or relaxation therapy for 12 sessions over a period of 14 weeks. All
children will undergo a 3-hour screening that will include a psychiatric evaluation and the
completion of questionnaires. Parents of participating children will attend the first two
treatment sessions without their children during which they will be introduced to the
treatment program and will learn various skills to be used throughout treatment. The other
10 1-hour sessions will be attended by both the parent and child. Participants assigned to
receive CBT will learn skills to help control OCD. Education about OCD, family therapy,
parent training to manage child behavior problems, and anxiety management will be included
in the CBT sessions. Participants assigned to receive relaxation therapy will discuss
general family functioning, issues related to OCD, and other behavioral problems the child
may be experiencing. Treatment will also include education about OCD; affective education,
during which participants will learn how to recognize feelings; muscle relaxation
techniques; and guided imagery. Participants in both treatment groups will receive weekly
homework assignments after each session to practice skills learned. Parents will also be
asked to monitor their child's behavior and practice the learned skills with their child as
often as possible. If treatment has not been successful after the 14-week period, the child
will be offered an alternative treatment. All participants will be assessed before
treatment; at 5, 9, and 14 weeks of treatment; and at 3, 6, and 12 months after treatment.

Inclusion Criteria:

- Meets DSM-IV criteria for OCD

- Parent willing to sign informed consent

Exclusion Criteria:

- History or current diagnosis of pervasive developmental disorder(s), thought
disorder, or mental retardation

- Psychotic symptoms