Better understanding the role of thinking styles and family factors in the treatment of children and adolescents with Obsessive Compulsive Disorder.

The treatment program involves 12 sessions (delivered over 14 weeks) of individual and family-based CBT based on a program entitled "Cognitive-Behavioral Treatment of Childhood OCD" (Piacentini, Langley, & Roblek, 2007). Individual sessions (with the child) are conducted weekly and family sessions (the child and at least one parent) are conducted every second session, in addition to the individual session. Each session lasts 60 minutes (family and individual). Child-focused sessions focus on psychoeducation about OCD, exposure and response prevention, and cognitive therapy to target unhelpful beliefs. Child-focused sessions also include a brief 10 to 15 minute check in with parents towards the end of the session to outline skills learnt in the session and home-practice activities. Homework assignments will involve exposure exercises (imaginal or in vivo) and behavioural experiments for the children and limits on accommodation for parent(s). In addition to accompanying their child to weekly child-focused sessions, parents are asked to attend six 60-minute family sessions with their child on a fortnightly basis. These sessions are in addition to the usual 60-minute session. On weeks where there is a family session scheduled, parents may not need to join the child-focused session. Family sessions conducted fortnightly involve both the parents and the child. Family sessions include education about OCD in order to reduce negative feelings of guilt and blame and to normalise family functioning in an OCD context. They are also designed to support families in better managing challenges associated with OCD. This includes assistance with managing emotions, improving communication and skills related to working well together as a family. The results pertaining to this manual show that 12 sessions over 14 weeks are adequate to achieve significant improvement in OCD symptoms and family functioning. The treatment program demonstrates comparable outcomes when compared to other well-regarded treatment manuals for pediatric OCD (e.g., Barrett, Healy-Farrell, & March, 2004; Pediatric OCD Treatment Study Team, 2004; Storch et al., 2007). This program was also selected due to suitability for both child and adolescent populations. In addition, the program includes a substantial family component relevant to research aims and in line with published literature highlighting the importance of targeting family factors to improve treatment outcomes. We are implementing an updated version of this manual (Peris & Piacentini, 2013). This updated CBT treatment manual has recently been trialled with improved outcomes compared to the original version (Peris & Piacentini, 2014; Piacentini, Langley, & Roblek, 2007). Written permission has been received from the authors of the manual to implement the updated program as part of the treatment tracking series. Treatment for the OCD treatment tracking series will be conducted by Sharlene Mantz (Registered Psychologist/USYD PhD candidate) and Chloe McGrath (Registered Clinical Psychologist/USYD MSc candidate). These clinicians are experienced in the assessment and treatment of OCD in children and adolescents, and have current working with children checks.