Children with obsessive-compulsive disorder (OCD) often do not receive cognitive behavioral therapy (CBT), the most effective intervention, in part because of geographic barriers and the lack of trained providers. Children with OCD frequently receive psychiatric medication alone or together with unproven forms of psychotherapy.
Stephen P. Whiteside, Ph.D., L.P., of the Department of Psychiatry & Psychology is using videophone technology to study the development of an efficient way to provide CBT to children with OCD through a one-week intensive therapy program.
"CBT can be delivered effectively in an intensive format over a three-week time span, which involves considerable time and financial expenditure for those who don't have local access," says Dr. Whiteside. "CBT delivered successfully in a five-day format has the potential to help many more families, whose children would otherwise remain untreated or inadequately treated."
The five-day intervention involves 10-hour sessions throughout the morning and afternoon. Mayo specialists educate children and their parents about how OCD works and use exposure and response prevention techniques, accomplishing as many exposures to symptoms as possible during treatment.
"We then teach parents to act as treatment coaches at home," says Dr. Whiteside. "The program is designed so the children don't need to work with a therapist when they return home."
Dr. Whiteside's team originally studied the five-day therapy with three adolescent patients. "The program worked," notes Dr. Whiteside. There appeared to be different paths to improvement. Some patients saw immediate improvement during the week that they then maintained at home. Others improved more gradually over time, suggesting that the families were able to successfully use the coaching strategies that they learned.
The study uses videophone technology to evaluate the five-day cognitive behavioral intervention for youth with OCD, administered at multiple sites. The children's symptoms are evaluated by specialists before and after treatment so that families who live a long distance from Mayo Clinic can participate in the study without making additional trips to Mayo.
Dr. Whiteside is partnering with the University of South Florida and the Fordham University to complete a baseline comparison study of 30 pediatric patients (10 children at each site). Mayo Clinic Center for Innovation also has provided funding to explore the use of smartphones to help families continue treatment at home.
"If our research confirms that this approach is effective, the program will be expanded to address other anxiety disorders," notes Dr. Whiteside.