Rosa-Alcázar Ana I, Iniesta-Sepúlveda Marina, Storch Eric A, Rosa-Alcázar Ángel, Parada-Navas José L, Olivares Rodríguez José
Department of Personality, Assessment and Psychological Treatment, University of Murcia, Spain.
Department of Psychology, Catholic University of Murcia, Spain; Department of Education, Catholic University of Murcia, Spain.
J Affect Disord. 2017 Jan 15;208:265-271. doi: 10.1016/j.jad.2016.09.060. Epub 2016 Oct 6.
Cognitive-Behavioral Family-Based Treatment (CBFT) is the standard of care in young children with OCD. Developmental considerations, parent desires, and cost-effective advantages motivate research to explore the relative efficacy of parent-only interventions. The main goal in this study was to test the effectiveness and feasibility of a parent only intervention for OCD in young children, comparing, in a preliminary fashion the relative efficacy of reducing obsessive-compulsive symptoms through two treatment conditions: 1) an individual CBFT for early OCD involving both parents and children, and 2) the family component of the intervention involving only individual Parent Training (PT).
Twenty treatment-seeking families from two private outpatient clinics in Spain were alternately assigned to one of the two treatment conditions. Participants had a primary diagnosis of OCD and a mean age of 6.62 years (65% males). Interventions were conducted by the same therapist and the assessments were administered by independent clinicians who were blind to the experimental conditions of the participants. Assessment time-points were pretreatment, posttreatment, and 3-month follow-up (including diagnosis, symptom severity, global functioning, family accommodation, externalizing and internalizing symptoms, and satisfaction measures).
The two ways of implementation, involving child and parents (CBFT) or involving only parents (PT), produced clinical improvements and were well-accepted by parents and children. The CBFT condition was superior to the PT condition in reducing externalizing problems.
reduced sample size and absence of randomization were the main limitations of this study.
these results suggest, in a preliminary manner, that the need to have the child present at session with the clinician could be decreased for some children, as well as the overall feasibility of working only with parents for the implementation of CBT for OCD in very young children.
基于认知行为的家庭治疗（CBFT）是患有强迫症的幼儿的标准治疗方法。发育方面的考虑、家长的意愿以及成本效益优势促使研究探索仅针对家长的干预措施的相对疗效。本研究的主要目标是测试仅针对家长的强迫症干预措施对幼儿的有效性和可行性，并以初步方式比较通过两种治疗条件减轻强迫症状的相对疗效：1）针对早期强迫症的个体CBFT，涉及父母和孩子双方；2）干预措施的家庭部分，仅包括个体家长培训（PT）。
来自西班牙两家私立门诊诊所的20个寻求治疗的家庭被交替分配到两种治疗条件之一。参与者的主要诊断为强迫症，平均年龄为6.62岁（65%为男性）。干预由同一位治疗师进行，评估由对参与者的实验条件不知情的独立临床医生进行。评估时间点为治疗前、治疗后和3个月随访（包括诊断、症状严重程度、整体功能、家庭适应、外化和内化症状以及满意度测量）。
两种实施方式，即涉及孩子和父母（CBFT）或仅涉及父母（PT），都产生了临床改善，并且被父母和孩子广泛接受。在减少外化问题方面，CBFT条件优于PT条件。
样本量减少和缺乏随机化是本研究的主要局限性。
这些结果初步表明，对于一些孩子来说，减少与临床医生会面时孩子在场的必要性是可行的，并且仅与父母合作实施针对幼儿强迫症的认知行为疗法总体上也是可行的。
