Cognitive behavioural therapy for children and adolescents with OCD works in the long term

November 15, 2017, Aarhus University

The vast majority of children and adolescents who receive cognitive behavioural therapy treatment for OCD thrive and live without symptoms a year after the end of treatment. This is shown by new research from Aarhus University's Centre for Child and Adolescent Psychiatry in Risskov.

Some children and adolescents think that they will have an accident if they do not count all the lampposts on their way to school. Or cannot leave the house unless they have washed their hands precisely 25 times. They suffer from OCD, , which is an extremely stressful psychiatric disorder that affects between 0.25 and 4 percent of all children.

Fortunately, cognitive behavioural therapy for OCD is both effective and well-documented. A large research study of OCD for children and adolescents aged seven to 17 now shows that cognitive behavioural therapy also has a long-lasting effect. The Nordic research project, which involves researchers from Aarhus University and and psychiatry clinics in Norway and Sweden, has shown that children and adolescents who benefited from the therapy were also free of patterns of compulsive behaviour and compulsive thoughts one year after the treatment ended.

"The study makes clear that cognitive behavioural therapy reaches beyond the treatment period. This knowledge is important, both for the practitioners, but not least for the affected children and their families," says Per Hove Thomsen, one of the researchers behind the study and professor at Aarhus University and consultant at the Centre for Child and Adolescent Psychiatry, Risskov. He is also a co-author of the report published in the Journal of the American Academy of Child and Adolescent Psychiatry.

"OCD is a very difficult disorder which demands a colossal amount of the child in question. It is almost impossible to live a normal life as a child and teenager with a normal level of development, if you need to wash your hands a hundred times a day in a particular way in order not to be killed, which is something that compulsive thinking can dictate. For the same reason, early intervention is necessary before the disorder has disabling consequences in adulthood," says Per Hove Thomsen.

The children in the study were treated with , which is a behavioural psychological treatment. Fundamentally, it involves supporting the child to refrain from acting on compulsive thoughts and instead incorporating new thought patterns. The method also involves the whole family, as the effect is strengthened by the parents supporting the child's use of methods to overcome OCD.

Furthermore, according to psychologist and PhD David R.M.A Højgaard, who is the lead author of the scientific article, once the treatment is completed, a watchful eye should still be kept on the child or teenager. "The results of the study indicate that to maintain the effect in the longer term, you need to remain aware and detect OCD symptoms so you can nip them in the bud before they develop and become worse. This is done by offering booster sessions to refresh the treatment principles and thereby prevent OCD from getting a foothold again," says David R.M.A Højgaard.

The collaboration with the Norwegian and Swedish child and adolescent psychiatry clinics has added knowledge that can be significant for the organisation of OCD treatment.

"The biggest challenge facing OCD treatment is that there are not enough specially trained therapists and treatment facilities to meet needs. The study shows that if the level of training of therapists is consolidated and if supervision is provided, then it is possible to provide treatment in an isolated corner of Norway that is just as effective as the treatment provided at a university clinic," says Per Hove Thomsen.

The study is part of The Nordic Long Term OCD Treatment Study (NordLOTS) and comprises 269 children and adolescents with OCD from Denmark, Norway and Sweden.

The results showed that 92 percent of the 177 and teenagers who immediately benefited from the treatment were still healthy and free of symptoms one year after the treatment ended. Of these, 78 percent had no clinical symptoms of OCD.

Explore further: Severe anxiety best treated with drugs and therapy

More information: Davíð R.M.A. Højgaard et al. One-Year Outcome for Responders of Cognitive-Behavioral Therapy for Pediatric Obsessive-Compulsive Disorder, Journal of the American Academy of Child & Adolescent Psychiatry (2017). DOI: 10.1016/j.jaac.2017.09.002

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