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Family Based Cognitive-Behavioral Therapy is Effective for Youth With OCD

newstudy-graphic-66x60.jpgA recent open trial conducted by researchers at the University of South Florida tested the effect of family-based cognitive-behavioral therapy (CBT) on children and adolescents with Obsessive-Compulsive Disorder (OCD). The participants were 30 youth (7-19 years old), half boys and half girls, who were partial or nonresponders to two or more medication trials. Each patient received 14 sessions of intensive family-based CBT.

At post-treatment and 3-month follow-up, 80% of participants had improved. Symptom severity was reduced by 54%. Over 50% were classified as being in remission at the end of treatment, and at the 3-month follow-up. While there was no notable difference in self-reported anxiety, researchers observed significant reductions in OCD-related impairment, depressive symptoms, behavioral problems, and family accommodation.

To read the entire article, click here: http://www.ncbi.nlm.nih.gov/pubmed/20390817

CBT and CBT Plus Medication for the Treatment of OCD in Children

NewStudy-Graphic-72x72_edited-3 A recent study published in Child and Adolescent Mental Health found both Cognitive Behavior Therapy (CBT) and CBT in combination with medication to be effective in the treatment of Obsessive Compulsive Disorder (OCD) in children. During a ten-year period, 75 children were evaluated and treated for OCD in an outpatient setting. Investigators later contacted a subset of that sample to investigate the long-term maintenance of their therapeutic gains. Treatment groups in this follow up investigation included, (1) those treated with medication before beginning CBT, (2) those treated with CBT only, and (3) those treated with CBT and medication, simultaneously. Participants in each group had all met diagnostic criteria for OCD as determined by their Children’s Yale Brown Obsessive-Compulsive Scale (CYBOCS) scores. Long term maintenance was assessed by comparing post-treatment and pre-treatment CYBOCS scores. Results showed significant improvement for each group, yielding further support for the use of CBT and CBT plus medication (SSRIs) in the treatment of OCD.

Reference

Nakatani, E. (2009). Outcomes of cognitive behaviour therapy for obsessive compulsive disorder in a clinical setting: A 10-year experience from a specialist OCD service for children and adolescents. Child and Adolescent Mental Health, 14, 133-139.

For children and adolescents, psychological harm of traumatic events reduced by CBT

In a review in the American Journal of Preventive Medicine, it was noted that children and adolescents who experience psychological harm caused by traumatic events are often treated by practitioners who are not aware of, and do not employ, treatments that are “based on the best available evidence.”

Meta-analyses were conducted on interventions that included cognitive behavioral therapy (CBT) in individual and group settings, play therapy, psychodynamic therapy, and others.

The traumas themselves covered a wide range and included sexual abuse, domestic violence, serious illness, and natural disasters. The CBT methods included exposure techniques, modification of inaccurate cognitions, reframing counterproductive cognitions regarding the trauma, and others.

Based on their analyses, the review authors concluded there was “strong evidence … that individual and group CBT can decrease psychological harm among symptomatic children and adolescents exposed to trauma.”

Review authors: H. R. Wethington, R. A. Hahn, D. S. Fuqua-Whitley, et al.

UK national guidelines emphasize CBT for children and adolescents

A recent article in Current Opinion in Psychiatry summarized the UK National Institute for Health and Clinical Excellence (NICE) clinical guidelines and reviews of cognitive behavioral therapy (CBT) for children and adolescents with mental health problems.

NICE is the UK’s independent organization responsible for providing national guidance on the “promotion of good health and the prevention and treatment of ill health.”

For the treatment of depression in children and young people, NICE guidelines recommended “that pharmacological approaches should not be the first-line approach to the treatment of depression in this age group.” It recommended instead “the initial use of psychosocial interventions, including CBT, for all severities of depression.”

Meta-analyses of randomized controlled trials suggested the importance of CBT for children and adolescents with generalized anxiety disorder, depression, obsessive compulsive disorder, and posttraumatic stress disorder. More limited evidence suggested CBT’s benefit in attention deficit hyperactivity disorder and others conditions.

The authors noted that CBT for these populations “should be extended by further primary and secondary research.”

Review authors: A. Munoz-Solomando, T. Kendall, C. J. Whittington

Antidepressants used in combination with CBT reduces risk of teen suicide

The use of the antidepressant fluoxetine (Prozac) alone has been associated with increased suicidality among teens and children, leading to black-box warnings on antidepressants in those populations. This in turn has caused serious concern in parents and has discouraged prescription, according to some researchers. A recent report on this issue focused on combining Cognitive Behavioral Therapy (CBT) with the fluoxetine and found that “adding CBT to medication enhances the safety of medication. Taking benefits and harms into account, combined treatment appears superior to either monotherapy as a treatment for major depression in adolescents.”

In a related report, the researchers added that cognitive behavior therapy “should be made readily available as part of comprehensive treatment for depressed adolescents” and added that such a shift in the current practice would be of “considerable public health relevance.”

Alternatives to Drugs for Hyperactive Children? Psychotherapy Can Help

 

A recent NY Times article talks about the prevalence of ADHD in children, and parents who want to avoid drugs like Ritalin. The American Psychological Association in fact recommends that parents consider non-drug treatment first for children. The article discusses one family that used new parenting techniques to help with their son’s ADHD, and also says that Cognitive Behavior Therapy has been demonstrated to help teach children how to improve their anger, frustration, depression, and anxiety. We actually just posted on how nurses used Cognitive therapy to help children ages 7-18 — see below…

Nurses Trained to use Cognitive Therapy with Children in Low-Income Communities

In a recent Philadelphia area pilot program, thirteen Advanced Practice Nurses (APNs) were trained by the Beck Institute to use Cognitive Therapy techniques to treat mental and behavioral health problems of children and adolescents between the ages of 7 and 18. The APNs were the children’s primary care providers in low-income populations, primary care providers are sometimes the only point of access for mental health care.

For this program, APNs were trained by Dr. Christine Reilly, a psychologist with expertise in Cognitive Therapy, and a nurse herself. The nurses participated in workshops, group supervision conference calls, and individual supervision sessions as needed, during the year-long program. The population served included children and adolescents from the Philadelphia region who presented with a range of problems, including depression, anxiety, behavioral problems, teen pregnancy, obesity, and substance abuse. The pilot program showed that nurses improved their understanding of the Cognitive Therapy model and CT techniques (developed by Aaron T. Beck, M.D. in the 1960s). Patients demonstrated improved outcomes, as assessed using the Beck Youth Inventories at the start and end of the program. Moreover, the nurses saw benefits of the CT training program in other aspects of their practice, including applying CT techniques to patients in other age groups, and improving the nurse/patient relationship.

This pilot program indicates that training nurses in Cognitive Therapy is a practical, feasible way to improve mental health care and patient outcomes among children and adolescents. The program was conducted by the National Nursing Centers Consortium, in partnership with the Beck Institute for Cognitive Therapy and Research, through a generous grant from the van Ameringen Foundation.

Research Results: New Review Shows CBT is Effective for Children & Adolescents with OCD

A new review shows that Cognitive Behavior Therapy (CBT) is effective for pediatric Obsessive Compulsive Disorder (OCD). CBT can reduce distress and interfering symptoms among children and adolescents with OCD, and reduce the risk of relapse. CBT is effective by itself, and is also effective with medication, more so than medication alone. This review evaluated four separate studies, which were all randomized controlled trials of CBT for OCD.