Family-Based Treatment for Young Children with OCD: Therapist Guide

Overview

Obsessive-compulsive disorder (OCD) can develop at a young age and when it does, it can cause significant distress for the child and the family. Parents may be unclear on the nature of OCD symptoms and how to best respond to their child. Family involvement in the child's symptoms may be making the situation worse for the whole family. When treating young children with OCD, it is important to recognize the family component and directly involve parents in treatment. It is also essential to tailor the treatment to a...

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Overview

Obsessive-compulsive disorder (OCD) can develop at a young age and when it does, it can cause significant distress for the child and the family. Parents may be unclear on the nature of OCD symptoms and how to best respond to their child. Family involvement in the child's symptoms may be making the situation worse for the whole family. When treating young children with OCD, it is important to recognize the family component and directly involve parents in treatment. It is also essential to tailor the treatment to a child's age and developmental level.

This therapist guide presents a family-based treatment for OCD specifically designed for children ages 5-8. Using a cognitive-behavioral approach, it provides psychoeducation for the family and a set of tools for the management of OCD. "Parent tools" involve differential attention, modeling, and scaffolding techniques. "Child tools" include cognitive strategies such as "bossing back" and using a feelings thermometer to rate anxiety. Treatment centers on exposure with response prevention (E/RP), in which the patient faces feared situations without avoidance or rituals until anxiety decreases. The therapist works with the family to create a hierarchy of E/RP tasks that will be conducted in session and practiced at home. A reward plan helps motivate the child to complete tasks and cooperate with parents. The program ends with relapse prevention to maintain gains and prepare for future symptoms. Therapy process issues are addressed throughout treatment to help families improve life at home.
With helpful tips for adapting the program to a child's developmental level and family situation, this guide is a "must-have" for clinicians working with childhood-onset OCD. The corresponding workbook for families reinforces the skills introduced in session and provides forms for homework. Children, their parents, and their families will all benefit from this comprehensive treatment package.

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Editorial Reviews

Doody's Review Service
Reviewer: Gary B Kaniuk, Psy.D.(Cermak Health Services)
Description: This book describes a cognitive-behavioral family intervention for young children (ages 5 to 8) who suffer from obsessive-compulsive disorder. The authors focus on cognitive strategies and E/RP (exposure with response prevention), a psychoeducational approach for both the child and his/her guardians.
Purpose: According to the authors, this book "is devoted to communicating these exciting new interventions for children and their parents to clinicians on the frontlines of practice." They note, "The overall focus of treatment is to provide parents and children with a set of 'tools' to help them understand, manage, and reduce OCD symptoms."
Audience: Clinicians serving the needs of young children with OCD and their families are the intended audience. Both authors are assistant professors at Brown University and co-directors of the Pediatric Anxiety Research Clinic (PARC). Dr. Freeman is the principal researcher for a study of obsessive-compulsive disorder and teaches/supervises psychology trainees. Dr. Garcia works extensively with children who are experiencing anxiety disorders and has published articles on obsessive-compulsive disorder and other childhood anxiety disorders.
Features: The book contains a 12-session program for addressing obsessive-compulsive disorder in young children, which should be combined with the parent workbook. The first two sessions are for parents only. The next nine sessions begin with an introduction and then proceed to explain the E/RP methodology. The final session is a review and celebration (graduation party). Chapters are uniformly organized covering: materials needed, outline, review of past week, problem solving about homework, review of hierarchy, in-session task, homework for parents and children. Each chapter contains numerous figures/charts which make the material easy to understand and teach. The step-by-step approach is very user-friendly. At the end of the book, there are "fidelity checklists" for each session so the therapist can see if he/she has presented the program the way it was designed. Also, the Family Accommodation and Impact Scale-Child (FAIS-C) and the Children's Yale Brown OC Scale (CY-BOCS) Self-Report Symptom Checklist are included. These two standardized measures are important tools in assessing both the child's symptoms and the family's accommodating behaviors.
Assessment: This excellent book presents an evidence-based treatment program that is easy for the therapist to use, and children with OCD and their parents can benefit from the practical ideas. This book will appeal to all clinicians who treat young children, but novice therapists will especially benefit from the well organized information. New graduates often will have some anxiety about their ability to manage treatment, but this wonderful guide will give them confidence.
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Product Details

  • ISBN-13: 9780195373639
  • Publisher: Oxford University Press, USA
  • Publication date: 9/10/2008
  • Series: Treatments That Work Series
  • Pages: 208
  • Sales rank: 639,839
  • Product dimensions: 6.90 (w) x 9.90 (h) x 0.40 (d)

Table of Contents

Chapter 1 Introductory Information for Therapists 1

Chapter 2 Assessment 23

Chapter 3 Session 1: Introduction to the Treatment Program (Parents Only) 31

Chapter 4 Session 2: Laying the Groundwork (Parents Only) 43

Chapter 5 Session 3: Child Introduction to the Treatment Program 59

Chapter 6 Session 4: Family-Based Treatment 81

Chapter 7 Session 5: E/RP / Modeling 95

Chapter 8 Session 6: E/RP / Introduction to Scaffolding 103

Chapter 9 Session 7: E/RP Using Parental Scaffolding 113

Chapter 10 Session 8: E/RP: Mid Hierarchy / Portability of Tools 123

Chapter 11 Session 9: E/RP: Mid Hierarchy / Extending Strategies 131

Chapter 12 Session 10: E/RP: Top of the Hierarchy / Preparation for Termination 139

Chapter 13 Session 11: E/RP: Top of the Hierarchy / Relapse Prevention 145

Chapter 14 Session 12: Review / Graduation Party 153

Fidelity Checklists 157

Family Accommodation and Impact Scale-Child (FAIS-C) 171

Children's Yale-Brown OC Scale (CY-BOCS) Self-Report Symptom Checklist 183

References 189

About the Authors 193

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