Family therapy helpful in young children with OCD
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Many young children who suffer from obsessive-compulsive disorder may get better with the help of psychological therapy that involves their parents as well, a small study suggests.
Children as young as 3 have been diagnosed with obsessive-compulsive disorder, or OCD, an anxiety disorder in which people have persistent, intrusive thoughts that drive them to ritualistically perform certain actions.
Someone with an obsessive fear of germs, for example, might wash his or her hands over and over throughout the day. In a young child, the same obsession might cause the child to repeatedly lick his or her hands.
A form of psychological counseling called cognitive behavioral therapy, or CBT, is considered the most effective therapy for OCD. It teaches people to retrain their thought patterns and realize that they do not have to resort to their obsessive behaviors to calm their anxiety.
However, few studies of CBT have included young children—those whose OCD symptoms arise before the age of 9.
Children this young are likely to need a tailored form of CBT that they can understand, and that involves their parents as well, according to Dr. Jennifer B. Freeman, the lead researcher on the new study.
So Freeman and her colleagues at Bradley Hasbro Children’s Research Center in Providence, Rhode Island, adapted the therapy into what they call family-based CBT. The goal, she explained in an interview, is to give both young children and their parents the “tools” to deal with OCD.
In the new study, published in the Journal of the American Academy of Child and Adolescent Psychiatry, the researchers looked at the effects of family-based CBT among 42, 5- to 8-year-olds with OCD. Some of the families were randomly assigned to 12 sessions of CBT, while the rest were assigned to family-based relaxation therapy.
The goal of the family-based CBT is the same as that of therapy for adults and older children—to make the children realize they do not have to resort to a compulsive behavior whenever they are in an anxiety-provoking situation.
Children who fear dirt and germs, for example, might be encouraged to take candy off the floor or “touch the trash,” Freeman explained. “Then we’ll say, ‘OK, let’s do jumping jacks with our hands dirty!’”
This, she said, shows these children they can deal with their anxiety without licking their hands or asking their parents to wash them.
Parents, meanwhile, learn about OCD and how to get over their own anxiety over their child’s distress.
At the end of the study, Freeman’s team found, 69 percent of the children who completed all 14 weeks of treatment were in clinical remission—meaning their OCD symptoms had improved to the point that they no longer needed therapy. That compared with 20 percent of children who completed the relaxation therapy program.
Being a newer concept, family-based therapy for young children’s OCD is not yet widely available. But, Freeman said, “we think it’s ready for prime time.”
SOURCE: Journal of the American Academy of Child and Adolescent Psychiatry, May 2008.
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