The purpose of this study is to evaluate a behavioral treatment program for children and
adolescents with OCD and their families. Exposure and Response Prevention (ERP) behavior
therapy, in which the patient is gradually exposed to the object or situation that causes
anxiety and is taught to refrain from responding in a compulsive manner, is combined with
family counseling (Family Treatment Program). This treatment will be compared to Relaxation
OCD is a long-term, often disabling disorder that can cause significant family disruption.
ERP is a promising treatment for children with OCD, and it is thought that family
participation (through the Family Treatment Program) may be a helpful addition. RT is a
common treatment for anxiety.
Patients are assigned randomly (like tossing a coin) to receive either the ERP/Family
Treatment Program or RT. Both treatments will be delivered over 12 90-minute outpatient
sessions to youngsters and their families. All participants (patients and family members)
will be assessed for treatment response each month during treatment, after treatment is
finished, and then at 2 follow-up visits over the following 6 months.
A child/adolescent may be eligible for this study if he/she:
Has obsessive-compulsive disorder (OCD), is medication-free, and is 8 to 17 years old.
To evaluate a standardized multicomponent cognitive behavioral treatment program for child
and adolescent obsessive-compulsive disorder (OCD). The treatment program consists of
individual Exposure and Response Prevention (ERP) for the OCD child plus a concurrent family
intervention designed to reduce OCD-related family conflict, facilitate family disengagement
from the affected child's OCD behavior, and rebuild normal family interaction patterns. The
ERP/Family Treatment Program is compared with Relaxation Training (RT).
OCD is a chronic, often disabling disorder in childhood that has been associated with
increased rates of parental psychopathology and significant disruptions in family
relationships and functioning. Preliminary studies suggest that ERP is an effective
treatment for children with OCD although no controlled trials to this effect have been
published. RT was selected as the comparison treatment because of its credibility as an
anxiety treatment and familiarity to potential subjects. RT has been used as a comparison
condition for at least 2 randomized controlled ERP trials for adult OCD and shown to be
ineffective in treating this disorder. Although it has long been hypothesized that family
participation in treatment may be helpful, this is the first controlled study incorporating
a systematic manualized family treatment component.
Participants are randomly assigned to receive either the combined ERP/Family Treatment
Program (n=56) or RT (n=24). Both treatments are delivered over 12 90-minute outpatient
sessions according to detailed treatment manuals.Youth and families undergo comprehensive
and systematic, including behavioral, assessments by blind clinical evaluators at baseline,
monthly during treatment, post-treatment and 2 follow-up evaluations over 6 months.
Treatment outcome is examined in multimodal fashion and across multiple functional domains
with a special emphasis on family contextual variables. The impact of baseline functioning,
including family context, and initial change over time on treatment outcome is also
Patients must have:
Obsessive-compulsive disorder for which he/she has not received medication.