Chessell Chloe, Halldorsson Brynjar, Walters Sasha, Farrington Alice, Harvey Kate, Creswell Cathy
School of Psychological and Clinical Language Sciences, University of Reading, UK.
Department of Experimental Psychology, University of Oxford, UK.
Behav Cogn Psychother. 2024 May;52(3):243-261. doi: 10.1017/S1352465823000450. Epub 2023 Oct 16.
Cognitive behavioural therapy (CBT) including exposure and response prevention (ERP) is an effective treatment for preadolescent children with obsessive compulsive disorder (OCD); however, there is a need to increase access to this treatment for affected children.
This study is a preliminary evaluation of the efficacy and acceptability of a therapist-guided, parent-led CBT intervention for pre-adolescent children (5-12 years old) with OCD using a non-concurrent multiple baseline approach.
Parents of 10 children with OCD were randomly allocated to no-treatment baselines of 3, 4 or 5 weeks before receiving six to eight individual treatment sessions with a Psychological Wellbeing Practitioner. Diagnostic measures were completed prior to the baseline, 1-week post-treatment, and at a 1-month follow-up, and parents completed weekly measures of children's OCD symptoms/impairment.
Seventy percent of children were 'responders' and/or 'remitters' on diagnostic measures at post-treatment, and 60% at the 1-month follow-up. At least 50% of children showed reliable improvements on parent-reported OCD symptoms/impairment from pre- to post-treatment, and from pre-treatment to 1-month follow-up. Crucially, the intervention was acceptable to parents.
therapist-guided, parent-led CBT has the potential to be an effective, acceptable and first-line treatment for pre-adolescent children with OCD, subject to the findings of further evaluations.
包括暴露与反应阻止法（ERP）在内的认知行为疗法（CBT）是治疗患有强迫症（OCD）的青春期前儿童的有效方法；然而，有必要让更多受影响的儿童能够获得这种治疗。
本研究采用非同期多重基线方法，对一种由治疗师指导、家长主导的针对患有强迫症的青春期前儿童（5 - 12岁）的CBT干预措施的疗效和可接受性进行初步评估。
10名患有强迫症儿童的家长被随机分配到在接受与心理健康从业者进行的六至八次个体治疗之前3周、4周或5周的无治疗基线期。在基线期之前、治疗后1周以及1个月随访时完成诊断测量，家长每周完成对儿童强迫症症状/损害的测量。
70%的儿童在治疗后诊断测量中为“有反应者”和/或“康复者”，在1个月随访时为60%。至少50%的儿童在家长报告的强迫症症状/损害方面从治疗前到治疗后以及从治疗前到1个月随访时显示出可靠的改善。至关重要的是，该干预措施为家长所接受。
根据进一步评估的结果，由治疗师指导、家长主导的CBT有可能成为治疗患有强迫症的青春期前儿童的一种有效、可接受的一线治疗方法。
