Family Cognitive Behavioral Therapy for Obsessive-Compulsive Disorder

Overseen By Diana Franco Yamin, MA

Age: < 65

Sex: Any

Trial Phase: Academic

Sponsor: University of British Columbia

Disqualifiers: Bipolar, Psychosis, Autism, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: 13

Duration: 12 weeks

180 Participants Needed

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial tests a new therapy approach for children and teens with Obsessive-Compulsive Disorder (OCD). The focus is on Group-based Family Cognitive-Behavioral Therapy (GF-CBT), involving the entire family in the treatment process. The goal is to compare the impact of this therapy on OCD symptoms to those of participants on a waitlist. Children and teens aged 5-18 with moderate to severe OCD, who can speak English and have parental consent, might be suitable candidates. As an unphased trial, this study provides a unique opportunity to contribute to innovative OCD treatment research.

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications. It focuses on therapy rather than medication changes.

What prior data suggests that Group-based Family CBT is safe for treating OCD?

Studies have shown that cognitive-behavioral therapy (CBT) effectively treats obsessive-compulsive disorder (OCD). Research supports its use, noting that it lacks the side effects often associated with medications. CBT is considered the best choice for treating OCD because it reduces symptoms and lowers the chance of symptoms returning after treatment ends.

Research also indicates that involving family in CBT, such as in group-based family cognitive-behavioral therapy (GF-CBT), can significantly improve results. This method not only addresses OCD symptoms but also enhances other areas of life for young people and their families.

Overall, GF-CBT is manageable and avoids the risks associated with medication, making it a safe option for effectively managing OCD symptoms. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about group-based family cognitive-behavioral therapy (GF-CBT) for obsessive-compulsive disorder (OCD) because it involves the family in the treatment process, which is different from many standard individual-focused therapies. Traditional treatments for OCD, like selective serotonin reuptake inhibitors (SSRIs) and individual cognitive-behavioral therapy (CBT), often overlook the important role of family dynamics in a patient's symptoms. GF-CBT harnesses the support system of the family to potentially enhance treatment outcomes and provide more sustainable results. This approach is promising because it not only addresses individual symptoms but also aims to improve the overall family environment, which can be crucial for long-term success.

What evidence suggests that Group-based Family CBT is effective for OCD?

Research has shown that group-based family cognitive-behavioral therapy (GF-CBT) can greatly benefit people with obsessive-compulsive disorder (OCD). Studies have found that GF-CBT not only reduces OCD symptoms but also enhances family interactions and functioning. Specifically, one study showed that this therapy significantly reduced OCD symptoms in teenagers. Cognitive-behavioral therapy is widely recognized as one of the best treatments for OCD. In this trial, participants in Group 1 will receive GF-CBT, while those in Group 2 will be on a waitlist for a treatment spot. These findings suggest that GF-CBT could be a promising option for families dealing with OCD. ^{2 5 6 7 8}

Who Is on the Research Team?

S. Evelyn Stewart, MD

Principal Investigator

University of British Columbia

Are You a Good Fit for This Trial?

This trial is for children and teens aged 5-18 with Obsessive-Compulsive Disorder (OCD). They must speak English, have a moderate to severe form of OCD, and be able to give informed consent along with their parents. Those with bipolar disorder, psychosis, mental retardation, autism spectrum disorders or substance abuse issues cannot participate.

Inclusion Criteria

I, and if applicable, my parent can give informed consent.

English-speaking

I have been diagnosed with severe childhood-onset OCD.

Exclusion Criteria

I have been diagnosed with psychosis.

I have been diagnosed with bipolar disorder.

Current diagnosis of pervasive developmental disorder (e.g., autism)

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants in Group 1 receive 12 sessions of Group-based Family CBT (GF-CBT)

12 weeks

12 sessions (in-person)

Follow-up

Participants are monitored for safety and effectiveness after treatment

4 weeks

1 visit (in-person)

What Are the Treatments Tested in This Trial?

Interventions

• Group-based family cognitive-behavioural therapy

Trial Overview The study tests Group-based Family Cognitive-Behavioral Therapy (GF-CBT) in treating pediatric OCD. Ninety participants will receive GF-CBT while another ninety on a waitlist serve as controls. The comparison focuses on changes in OCD severity and functioning after twelve GF-CBT sessions.

How Is the Trial Designed?

Group I: OCD-affected subjects (Group 1) Active Control 1 Intervention

OCD-affected subjects will participate in 12 sessions of group therapy (as per GF-CBT protocol).

Group II: OCD-affected subjects (Group 2) Active Control 1 Intervention

Waitlist affected-controls awaiting a treatment spot.

Who Is Running the Clinical Trial?

University of British Columbia

Lead Sponsor

Trials

1,506

Recruited

2,528,000+

Michael Smith Foundation for Health Research

Collaborator

Trials

20

Recruited

6,100+

Published Research Related to This Trial

This study is a randomized clinical trial comparing family-based cognitive behavioral therapy (FCBT) to family-based psychoeducation and relaxation training (FPRT) in children and adolescents aged 8-17 with obsessive-compulsive disorder (OCD), aiming to include at least 128 participants to ensure robust results.

The trial is designed to minimize bias and enhance the reliability of findings by using blinding for assessors and randomizing therapists to deliver both interventions, allowing for a clearer understanding of the specific benefits and harms of FCBT compared to FPRT.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Family-based cognitive behavioural therapy versus family-based relaxation therapy for obsessive-compulsive disorder in children and adolescents: protocol for a randomised clinical trial (the TECTO trial). Pagsberg, AK., Uhre, C., Uhre, V., et al.[2022]

A study involving 77 children and adolescents with OCD found that both individual and group cognitive-behavioral family-based therapy (CBFT) significantly reduced OCD symptoms, with no notable differences in effectiveness between the two treatment formats.

The improvements in OCD symptoms were maintained for up to 6 months after treatment, demonstrating the long-lasting efficacy of CBFT for childhood OCD.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Cognitive-behavioral family treatment of childhood obsessive-compulsive disorder: a controlled trial. Barrett, P., Healy-Farrell, L., March, JS.[2018]

Cognitive Behavior Therapy (CBT) for treating OCD in young people is effective regardless of the level of parental involvement, as both high and low parental involvement led to significant reductions in OCD symptoms.

While both CBT methods were effective, parent-enhanced CBT showed a potential for greater reductions in anxiety symptoms, suggesting that parental involvement may have some benefits, although this study was small and further research is needed.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Randomized controlled trial of parent-enhanced CBT compared with individual CBT for obsessive-compulsive disorder in young people. Reynolds, SA., Clark, S., Smith, H., et al.[2022]

In a study of 30 obsessive-compulsive patients, those who received family-based therapy with a trained family member as a cotherapist showed significantly greater improvements in anxiety, depression, obsessive symptoms, and social adjustment compared to those who received individual treatment.

The effectiveness of the family-based approach was also influenced by the personality patterns of the family members involved, suggesting that family dynamics play a role in treatment outcomes.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A comparative study of family-based and patient-based behavioural management in obsessive-compulsive disorder. Mehta, M.[2019]

This study will analyze adverse events in psychotherapy for youth with OCD by including at least 128 participants aged 8-17, comparing family-based cognitive behavioral therapy (FCBT) and family-based psychoeducation and relaxation training (FPRT).

The mixed methods approach will combine quantitative assessments of adverse events with qualitative interviews to better understand their nature and causes, aiming to improve the safety and effectiveness of psychotherapy for OCD.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Adverse events in cognitive behavioral therapy and relaxation training for children and adolescents with obsessive-compulsive disorder: A mixed methods study and analysis plan for the TECTO trial. Pretzmann, L., Christensen, SH., Bryde Christensen, A., et al.[2023]

Family dynamics significantly influence the treatment response of individuals with obsessive-compulsive disorder (OCD), with extreme responses—either overly accommodating or overly antagonistic—linked to poorer outcomes in exposure and response prevention (ERP) and pharmacotherapy.

Involving family members in treatment, such as having them participate as coaches or co-therapists, may improve treatment effectiveness for OCD patients, suggesting that family-based interventions could be beneficial.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Involving family members in the treatment of OCD. Renshaw, KD., Steketee, G., Chambless, DL.[2022]

Family dynamics, such as parental attachment and expressed emotion, can significantly influence the treatment outcomes for patients with obsessive-compulsive disorder (OCD), with negative family interactions potentially hindering progress.

Involving family members in treatment, particularly for children, shows promise, especially when focusing on reducing family accommodation and implementing behavioral contracts for exposure therapy.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Family approaches to treatment for obsessive compulsive disorder. Steketee, G., Van Noppen, B.[2022]

Cognitive-behavioral family therapy for childhood obsessive-compulsive disorder (OCD) showed long-term effectiveness, with 70% of participants in individual therapy and 84% in group therapy remaining diagnosis-free at 12 to 18 months post-treatment.

The study found that higher initial severity of OCD symptoms and greater family dysfunction were predictors of poorer long-term outcomes, suggesting that addressing family dynamics could enhance treatment effectiveness.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Cognitive-behavioral family treatment of childhood obsessive-compulsive disorder: long-term follow-up and predictors of outcome. Barrett, P., Farrell, L., Dadds, M., et al.[2022]

Citations

1. pubmed.ncbi.nlm.nih.gov pubmed.ncbi.nlm.nih.gov/29179016/

Group family-based cognitive behavioral therapy for ... This study provides evidence that GF-CBT significantly improves a wide range of domains for youth/families that extends beyond OCD symptom severity.

2. sciencedirect.com sciencedirect.com/science/article/abs/pii/S0165178117308168

Group family-based cognitive behavioral therapy for ... This study provides evidence that GF-CBT significantly improves a wide range of domains for youth/families that extends beyond OCD symptom severity and supports ...

3. clinicaltrials.gov clinicaltrials.gov/study/NCT04891367

Cognitive Behavioral Group Treatment for Obsessive ... For benchmarking of treatment outcomes, the project will compare the results from the group-based CBT with data from 45 Danish patients previously enrolled in ...

4. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC9375669/

Efficacy of group cognitive-behavioral therapy in ... The main findings suggest that GCBT is effective in reducing the symptoms of OCD in adolescents (d = -1.32).

5. psychiatryonline.org psychiatryonline.org/doi/10.1176/appi.focus.20210015

Cognitive-Behavioral Therapy for Obsessive-Compulsive ... Cognitive-behavioral therapy (CBT) remains one of the most effective treatments for obsessive-compulsive disorder (OCD).

6. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC11170287/

Cognitive-Behavioral Therapy for Obsessive-Compulsive ... Cognitive-behavioral therapy (CBT) is the front-line psychotherapeutic treatment of OCD supported by a substantial body of theoretic and empirical support.

7. sciencedirect.com sciencedirect.com/science/article/pii/S1697260019300699

Family involvement and treatment for young children with ... The aim of this paper was to evaluate the diferential efficacy of cognitive behavioral family treatment in children under 8 years of age with Obsessive- ...

8. link.springer.com link.springer.com/article/10.1007/s00787-025-02797-4

Family-based cognitive behavioral therapy versus ... We investigated benefits and harms of family-based CBT with exposure and response prevention (FCBT) versus family-based psychoeducation and ...