Family Based Treatment for Young Children With OCD: Therapist Guide

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Oxford University Press, USA, Sep 10, 2008 - Medical - 193 pages
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.
 

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Contents

Chapter 1 Introductory Information for Therapists
1
Chapter 2 Assessment
23
Introduction to the Treatment Program Parents Only
31
Laying the Groundwork Parents Only
43
Child Introduction to the Treatment Program
59
FamilyBased Treatment
81
ERP Modeling
95
ERP Introduction to Scaffolding
103
ERP Mid Hierarchy Extending Strategies
131
ERP Top of the Hierarchy Preparation for Termination
139
ERP Top of the Hierarchy Relapse Prevention
145
Review Graduation Party
153
Fidelity Checklists
157
Family Accommodation and Impact ScaleChild FAISC
171
Childrens YaleBrown OC Scale CYBOCS SelfReport Symptom Checklist
183
References
189

ERP Using Parental Scaffolding
113
ERP Mid Hierarchy Portability of Tools
123
About the Authors
193
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About the author (2008)

Jennifer Freeman is Assistant Professor (Research), Department of Psychiatry and Human Behavior, Brown Medical School, Staff Psychologist, Rhode Island Hospital, Division of Child and Family Psychiatry and Co-Director of the Pediatric Anxiety Research Clinic. Abbe Marrs Garcia AssistantProfessor (Research), Department of Psychiatry and Human Behavior, Brown Medical School, Staff Psychologist, Rhode Island Hospital, Division of Child and Family Psychiatry.

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