Enhanced Cognitive Behavioral Therapy for children and adolescents with Obsessive-Compulsive Disorder

Pediatric obsessive compulsive disorder (OCD) is a relatively common, severe,
and debilitating condition. Cognitive behavioral therapy (CBT) is the
first-line treatment for pediatric OCD. However, treatment for OCD is hampered
by several problems. Average improvement rates are limited and there are large
individual differences in treatment effect. There are organizational and
practical barriers to treatment for OCD. The availability of this treatment is
limited because of a shortage of experienced therapists, CBT is often poorly
implemented and there are long waiting lists for treatment New technologies
offer the opportunity to improve accessibility, user friendliness, and
effectiveness of traditional office-based cognitive behavioral therapy (CBT).

To examine the feasibility and acceptability, and preliminary efficacy, of a
new developed enhanced CBT (eCBT) for pediatric obsessive-compulsive disorder

Open trial

Enhanced Cognitive Behaviour Therapy (eCBT) is traditionally office-based
cognitive behavioral therapy, adding real-time, interactive videoconferencing
technology and a smart phone application.
The treatment consists of 10 in-office face-to-face sessions and 12
videoconferencing sessions (therapist guided exposure exercises at home) in 14
weeks. The treatment contains psychoeducation about OCD and treatment,
administration of symptoms, exposure with response prevention (ERP), supportive
cognitive interventions, and relapse prevention. Parents are involved in the
treatment.

There are very little or even no risks for participants of the present study
related to the treatment. Enhanced CBT (eCBT) is a new framework for providing
treatment based on well-validated principles of CBT. By employing an integrated
and age appropriate technological package, a more intensive and focused
application of CBT principles can be executed. Furthermore, integrating new
technologies may provide treatment that is more easily accessible, user
friendly, and motivating, and may be attractive for youth. Therefore, and given
current empirical support for the efficacy of CBT for the treatment of
pediatric OCD, research participants are offered the usual, evidence-based
treatment, but in a format that may offer more convenience (the main part of
the treatment sessions will be at home, via video link, which reduces
travelling costs and time, and stigmatizing). The video sessions at home may
make the treatment more ecologically valid, and use of the app may enhance
motivation.
However, a possible disadvantage of study participation is the completion of
some extra questionnaires.
Furthermore, although strict security measures are taken, risks related to
technology and security can't be excluded. In addition, we can't exclude the
risk of faltering technology and loss of connectivity during the video linking.
When this happens, the therapist will try to find a solution together with the
patient.