AUTHOR=Selles Robert R. , Naqqash Zainab , Best John R. , Franco-Yamin Diana , Qiu Serene T. , Ferreira Jessica S. , Deng Xiaolei , Hannesdottir Dagmar Kr. , Oberth Carla , Belschner Laura , Negreiros Juliana , Farrell Lara J. , Stewart S. Evelyn 

TITLE=Effects of Treatment Setting on Outcomes of Flexibly-Dosed Intensive Cognitive Behavioral Therapy for Pediatric OCD: A Randomized Controlled Pilot Trial

JOURNAL=Frontiers in Psychiatry

VOLUME=12

YEAR=2021

URL=https://www.frontiersin.org/journals/psychiatry/articles/10.3389/fpsyt.2021.669494

DOI=10.3389/fpsyt.2021.669494

ISSN=1664-0640

ABSTRACT=<p><bold>Introduction:</bold> Optimizing individual outcomes of cognitive-behavioral therapy (CBT) remains a priority.</p><p><bold>Methods:</bold> Youth were randomized to receive intensive CBT at a hospital clinic (<italic>n</italic> = 14) or within their home (<italic>n</italic> = 12). Youth completed 3 × 3 h sessions (Phase I) and up to four additional 3-h sessions as desired/needed (Phase II). An independent evaluator assessed youth after Phase I, Phase II (when applicable), and at 1- and 6-months post-treatment. A range of OCD-related (e.g., severity, impairment) and secondary (e.g., quality of life, comorbid symptoms) outcomes were assessed.</p><p><bold>Results:</bold> Families' satisfaction with the treatment program was high. Of study completers (<italic>n</italic> = 22), five youth (23%) utilized no Phase II sessions and 9 (41%) utilized all four (Median Phase II sessions: 2.5). Large improvements in OCD-related outcomes and small-to-moderate benefits across secondary domains were observed. Statistically-significant differences in primary outcomes were not observed between settings; however, minor benefits for home-based treatment were observed (e.g., maintenance of gains, youth comfort with treatment).</p><p><bold>Discussion:</bold> Intensive CBT is an efficacious treatment for pediatric OCD. Families opted for differing doses based on their needs. Home-based treatment, while not substantially superior to hospital care, may offer some value, particularly when desired/relevant.</p><p><bold>Clinical Trial Registration:</bold><ext-link ext-link-type="uri" xlink:href="http://www.ClinicalTrials.gov" xmlns:xlink="http://www.w3.org/1999/xlink">www.ClinicalTrials.gov</ext-link>; <ext-link ext-link-type="uri" xlink:href="https://clinicaltrials.gov/ct2/show/NCT03672565" xmlns:xlink="http://www.w3.org/1999/xlink">https://clinicaltrials.gov/ct2/show/NCT03672565</ext-link>, identifier: NCT03672565.</p>