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Clinician guide may improve exposure and response prevention implementation for OCD

PHILADELPHIA — An exposure therapy guide improved therapist behaviors among community mental health therapists treating youth with obsessive-compulsive disorder, suggesting the guide may help increase implementation of exposure and response-prevention therapy.

“We wanted to look at different therapist behaviors and how they were affecting exposure and response prevention for treating pediatric OCD,” Victoria Peloquin, BA, a volunteer research assistant at Brown University, Lifespan Hospitals, Providence, R.I., told Healio.com/Psychiatry. “We noticed that even though this treatment was very efficacious, a lot of community mental health therapists were not practicing exposure and response prevention. So we were trying to find a tool that would help teach these therapists and also make it easier for them to understand how to conduct these exposures.”

Following an 8-hour session on OCD, related behaviors and treatment, six therapists treating pediatric outpatients with OCD in a community mental health center entered baseline training from 6 to 16 weeks. This included weekly supervision and revision of therapy sessions with children via video. After baseline training, participants entered the exposure therapy guide phase, in which they worked through a guide on specific therapist behaviors that would help with treating OCD. Participants attended weekly group meetings to help them enact recommended behaviors.

Therapist beliefs about exposure and anxiety-decreasing behaviors significantly changed between study entry and end of baseline, but not between end of baseline and end of the therapy guide phase. This indicated that supervisors may have unknowingly given more information than necessary about their own therapist behaviors, according to Peloquin.

Of the five therapists who did not meet behavioral benchmarks in the baseline phase, three met benchmarks during the therapy guide phase for at least three consecutive sessions.

“Our findings indicated that the exposure guide was helpful. I think testing the guide among a wider range of therapists will garner more study power and help us figure out exactly what works,” Peloquin said.

The study is currently in phase 2 and has expanded to include anxiety disorders in addition to OCD, as well as a larger pool of clinicians. – by Amanda Oldt

Reference:

Peloquin V, et al. CBT for pediatric OCD: Preliminary results from a community training pilot. Presented at: Anxiety and Depression Association of America Conference; March 31-April 3, 2016; Philadelphia.

Disclosure: Peloquin reports no relevant financial disclosures.