Family Based Treatment for Young Children With OCD: Therapist Guide (Treatments That Work)

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.

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.

Doody Review Services

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.

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. Introductory information for facilitators Assessment Introduction to the treatment program (parents only) Laying the groundwork (parents only) Child introduction to treatment program (parents and child) Family based treatment (parents and child) ERP/modeling ERP/introduction to scaffolding ERP using parental scaffolding ERP: mid hierarchy/portability of Tools ERP: mid hierarchy/extending strategies ERP: top of the hierarchy/preparation for termination ERP: top of the hierarchy/relapse prevention Review and graduation party. This therapist guide presents a family-based treatment for OCD specifically designed for children ages 5-8. Using a cognitive-behavioural approach, it provides psycho-education for the family and a set of parent strategies involving differential attention, modelling, and scaffolding techniques, and child strategies that include cognitive tools such as 'bossing back' and using a feelings thermometer to rate anxiety