None listed
Conditions
Brief summary
This study aims to evaluate a new, accessible treatment approach for children with obsessive–compulsive disorder (OCD). The program, called FAST-ERP, supports parents to learn practical skills through online modules and telehealth sessions so they can help their child manage OCD symptoms at home. FAST-ERP will be compared to the current gold-standard treatment, where children receive individual cognitive behavioural therapy (CBT) with a clinician via telehealth. The study will assess whether FAST-ERP is as effective (non-inferior) as standard CBT in reducing OCD symptoms and improving children’s daily functioning.
Interventions
FAST-ERP. The multi-technology intervention involves two components, a) parents accessing web-based modules and b) parents participating in group telehealth training sessions.
a) Web-based modules. OCD Busters parent training web-based modules, hosted on Griffith servers via secure parent login, consisting of 4 educational modules training parents to be ‘ERP coaches’, managing child OCD symptoms, and reducing family accommodation. The content of the 4 modules includes (1) Psychoeducation on ERP
FAST-ERP. The multi-technology intervention involves two components, a) parents accessing web-based modules and b) parents participating in group telehealth training sessions. a) Web-based modules. OCD Busters parent training web-based modules, hosted on Griffith servers via secure parent login, consisting of 4 educational modules training parents to be ‘ERP coaches’, managing child OCD symptoms, and reducing family accommodation. The content of the 4 modules includes (1) Psychoeducation on ERP – explaining its purpose and how it is used to treat OCD; (2) Facing and Fighting Plans – developing fear hierarchies for ERP; (3) OCD Busting – how to implement ERP at home and in various contexts using contingency management strategies; and (4) Overcoming Obstacles – addressing common obstacles for the parent, child, and context in implementing ERP. The parents work independently through one module a week for 4 weeks. At the start of each of the four ~30-minute web-based modules, parents complete brief online progress ratings (parent confidence, child motivation, and recent OCD severity/interference), the full parent-rated Child Yale-Brown Obsessive Compulsive Scale (CY-BOCS) at enrolment, and a weekly 10-item CY-BOCS checklist, with all responses securely stored in the program backend for later download and analysis. The web-based program (https://ocdbusters.griffith.edu.au) is hosted by Griffith University and was launched July 2022 following extensive security testing by Griffith’s Digital Solutions. This treatment protocol has been piloted and trialled in videoconference format (Farrell & Waters, 2008; Farrell et al., 2022) b) Parent group telehealth sessions. The second component involves parents to participate in 4 weekly, one hour small group parent sessions delivered via videoconference (Microsoft Teams), facilitated by a masters-level clinician (supervised by CI Farrell) to support implementation of ERP. The parent sessions will consist of 4-6 parents. The content of sessions focusses on discussion of the content delivered in the corresponding web-based modules, and involves discussion of how parents will implement strategies at home, including setting homework tasks, problem solving challenges, and strategies to support children's progress at home. Monitoring Following the web-based and telehealth group meetings (after session 4), a single, one-hour joint parent–child telehealth session will be conducted by a clinician to review progress, implement ERP strategies, and support ongoing exposure practice. It is scheduled in the 2-3 weeks following module 4. In addition, parents will receive a brief weekly 15-minute clinician check-in call to reinforce and encourage continued ERP implementation. Finally, a tele-health group booster session (via Microsoft Teams) will be held at Week 8 to reconvene parents, review progress, and support planning for continued ERP practice with their children.
Sponsors
Griffith University
Study design
Allocation
Randomised controlled trial
Intervention model
Parallel
Primary purpose
Treatment
Masking
Blinded (masking used) (Investigator, Outcomes Assessor)
Eligibility
Sex/Gender
All
Age
7 Years to 65 Years
Healthy volunteers
No
Inclusion criteria
For youth: (1) youth 7 to 18 years; (2) primary diagnosis of OCD, as assessed by DSM-5 compatible Anxiety Disorders Interview Schedule for Children - Parent Interview; (3) willingness to be randomised to one of two active treatments; (4) lives with a parent who is willing and able to attend telehealth sessions; (5) English speaking; (6) stable dose of any psychopharmacotherapy 12 weeks (since initiation) or 6 weeks (since dose change) prior to entry and willingness to remain on stable dose. For Parents: (1) english speaking; (2) willingness to participate in a parent-led intervention; (3) access to internet.
Exclusion criteria
(1) concurrent psychotherapy; (2) child comorbid conduct disorder, bipolar, psychotic illness, eating disorder, or substance abuse; (3) symptoms consistent with PANS/PANDAS given the acute and fluctuating nature (Murphy et al., 2005; Swedo et al., 1998; 2002) and lack of consensus regarding diagnosis (Swedo et al., 2004). CI Farrell & Perkes will consult regarding each suspected case; (4) active suicidality; (5) suspected impaired IQ making completion of measures challenging (parent & child).
Outcome results
None listed