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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.
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
About the Authors 193