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?

Obsessive-Compulsive Disorder (OCD) is a common neuropsychiatric illness beginning in childhood. Effective OCD treatments include cognitive-behaviour therapy (CBT) and medications but access to treatment is difficult and does not systematically include parents. The investigators will evaluate clinical and neural effects of Group-based Family CBT (GF-CBT), via a case-control study including: Group 1 - OCD cases receiving GF-CBT (N=90); Group 2 - OCD waitlist cases (N=90). Effects will be measured between baseline and completion of 12 GF-CBT sessions: comparing OCD severity and functioning changes between Groups 1 and 2.

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.

Is family cognitive behavioral therapy safe for treating obsessive-compulsive disorder?

Research on family cognitive behavioral therapy (CBT) for obsessive-compulsive disorder (OCD) in children and adolescents is limited in terms of safety data. However, no specific safety concerns have been highlighted in the studies reviewed, and family-based interventions are generally considered safe. ^{1 2 3 4 5}

How does family cognitive behavioral therapy differ from other treatments for OCD?

Family cognitive behavioral therapy for OCD is unique because it involves training a family member to act as a co-therapist at home, which can lead to greater improvements in anxiety, depression, and social adjustment compared to treatments focusing only on the patient. This approach leverages the family environment to enhance treatment effectiveness by reducing negative family responses and increasing support. ^{3 4 5 6 7}

What data supports the effectiveness of the treatment Group-based family cognitive-behavioral therapy for Obsessive-Compulsive Disorder?

Research shows that involving family members in therapy for OCD can lead to better outcomes, as family members can act as co-therapists and help reduce negative responses to symptoms. Studies have found that family-based approaches can improve anxiety, depression, and social adjustment in patients with OCD. ^{3 4 5 6 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

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]

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]

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]

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]

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]

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]

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]

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]

Citations

1. Brazil pubmed.ncbi.nlm.nih.gov

Family approaches to treatment for obsessive compulsive disorder. [2022]

2. England pubmed.ncbi.nlm.nih.gov

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

3. United States pubmed.ncbi.nlm.nih.gov

Cognitive-behavioral family treatment of childhood obsessive-compulsive disorder: a controlled trial. [2018]

4. England pubmed.ncbi.nlm.nih.gov

Involving family members in the treatment of OCD. [2022]

5. United States pubmed.ncbi.nlm.nih.gov

Cognitive-behavioral family treatment of childhood obsessive-compulsive disorder: long-term follow-up and predictors of outcome. [2022]

6. England 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). [2022]

7. Netherlands 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. [2023]

8. United States pubmed.ncbi.nlm.nih.gov

Randomized controlled trial of parent-enhanced CBT compared with individual CBT for obsessive-compulsive disorder in young people. [2022]