Pediatric OCD presents significant symptoms, comorbidity, and functional impairments that can persist into adulthood, yet effective treatments, particularly cognitive-behavioral therapy (CBT) combined with exposure plus response prevention (ERP), have been established. Drs. Franklin and Piacentini will commence with a critical review of the pediatric OCD treatment literature, highlighting key randomized trials that demonstrate the efficacy of ERP alone and in conjunction with serotonin reuptake inhibitors (SRIs). They will delve into common clinical barriers to optimal outcomes, including low motivational readiness, unusual obsessional fears (such as being buried alive or trapped in someone else’s dream), and the management of suicidal ideation linked to obsessive thoughts. Additional complexities include the effects of psychiatric comorbidity, family accommodation, and other factors that can negatively impact OCD treatment outcomes. The presentation will incorporate case examples to illustrate recommended clinical procedures for navigating these challenges. Furthermore, there will be ample opportunity for audience questions and discussions, allowing participants to share their own theoretical and clinical experiences, including case presentations. Emphasis will be placed on providing effective clinical services for pediatric OCD patients and their families, particularly those who have previously shown partial or no response to CBT, pharmacological interventions, or combined treatment approaches, alongside addressing family-related complexities that may hinder effective treatment delivery.
Suggested Reading
Freeman, J., Benito, K., Herren, J., Kemp, J., Sung, J., Georgiadis, C., Arora, A., Walther, M., & Garcia, A. (2018). Evidence base update of psychosocial treatments for pediatric obsessive-compulsive disorder: Evaluating, improving, and transporting what works. Journal of Clinical Child and Adolescent Psychology: The Official Journal for the Society of Clinical Child and Adolescent Psychology, American Psychological Association, Division 53, 47(5), 669–698. https://doi.org/10.1080/15374416.2018.1496443
Ivarsson, T., Skarphedinsson, G., Kornør, H., Axelsdottir, B., Biedilæ, S., Heyman, I., Asbahr, F., Thomsen, P. H., Fineberg, N., March, J., & Accreditation Task Force of The Canadian Institute for Obsessive Compulsive Disorders. (2015). The place of and evidence for serotonin reuptake inhibitors (SRIs) for obsessive-compulsive disorder (OCD) in children and adolescents: Views based on a systematic review and meta-analysis. Psychiatry Research, 227(1), 93–103. https://doi.org/10.1016/j.psychres.2015.01.015
Kemp, J., Barker, D., Benito, K., Herren, J., & Freeman, J. (2021). Moderators of psychosocial treatment for pediatric obsessive-compulsive disorder: Summary and recommendations for future directions. Journal of Clinical Child and Adolescent Psychology: The Official Journal for the Society of Clinical Child and Adolescent Psychology, American Psychological Association, Division 53, 50(4), 478–485. https://doi.org/10.1080/15374416.2020.1790378
Piacentini, J., Wu, M., Rozenman, M., Bennett, S., McGuire, J., Nadeau, J., Lewin, A., Sookman, D., Bergman, R. L., Storch, E. A., & Peris, T. (2021). Knowledge and competency standards for specialized cognitive behavior therapy for pediatric obsessive-compulsive disorder. Psychiatry Research, 299, Article 113854. https://doi.org/10.1016/j.psychres.2021.113854
Peris, T., & Piacentini, J. (2014). Addressing barriers to change in the treatment of childhood obsessive-compulsive disorder. Journal of Rational-Emotive & Cognitive-Behavior Therapy, 32, 31–43.
Peris, T., O’Neill, J., Rozenman, M., Bergman, R. L., Chang, S., & Piacentini, J. (2017). Developmental and clinical predictors of comorbidity for youth with obsessive-compulsive disorder. Journal of Psychiatric Research, 93, 72–78.
Skarphedinsson, G., Weidle, B., Thomsen, P. H., Dahl, K., Torp, N. C., Nissen, J. B., Melin, K. H., Hybel, K., Valderhaug, R., Wentzel-Larsen, T., Compton, S. N., & Ivarsson, T. (2015). Continued cognitive-behavior therapy versus sertraline for children and adolescents with obsessive-compulsive disorder that were non-responders to cognitive-behavior therapy: A randomized controlled trial. European Child & Adolescent Psychiatry, 24(5), 591–602. https://doi.org/10.1007/s00787-014-0613-0
Tuerk, P., McGuire, J., & Piacentini, J. (2024). A randomized controlled trial of OC-Go for childhood obsessive-compulsive disorder: Augmenting homework compliance in exposure with response prevention treatment. Behavior Therapy, 55, 306–319.
Peris, T., Rozenman, M., Sugar, C., McCracken, J., & Piacentini, J. (2017). Targeted family intervention for complex cases of pediatric obsessive-compulsive disorder: A randomized controlled trial. Journal of the American Academy of Child & Adolescent Psychiatry, 56, 1034–1042.
CE Learning Objective:
By the end of this program, participants will be able to:
1. Recognize the three most common psychiatric comorbidities in pediatric OCD and the accompanying clinical strategies to mitigate their effects.
2. Name the recommended strategies used to address predictors of negative response including low motivation and suicidal ideation in the context of obsessions pertaining to suicide.
3. Identify the clinical strategies used to address family accommodation at various stages of treatment and promote empirically supported techniques to encourage families to work together towards productive solutions in treatment.
4. Identify the two core OCD symptoms in youth and the rationale for CBT Apply a method of clinical decision-making when comorbid disorders are present
5.Be able to identify and address the three most common barriers to successful intervention
6. Recognize the potential augmentative value of family-based interventions to address accommodation
ABOUT THE PRESENTERS
Dr. John Piacentini
Dr. John Piacentini is Professor of Psychiatry and Biobehavioral Sciences at the UCLA Semel Institute where he directs the Child OCD, Anxiety and Tic Disorders Clinic/Tourette Association of America (TAA) Center of Excellence and the Center for Child Anxiety, Resilience, Education and Support (CARES). A board-certified psychologist, his work focuses on the development and dissemination of treatments for youth with OCRDs, anxiety and tics. He has authored over 350 scientific publications, including nine books and treatment manuals, and received research funding from NIMH, PCORI, IOCDF, and other foundations. Dr Piacentini has been an IOCDF Behavior Therapy Training Institute faculty member for almost 20 years and he has led numerous other national and international therapy trainings for OCD and related disorders. In addition, he is a member of the IOCDF Scientific and Clinical Advisory Board, and chairs the TLC Foundation for BFRBs and Tourette Association of America Scientific Advisory Boards.
Dr. Martin E. Franklin
Martin E. Franklin is an internationally recognized expert in the phenomenology, assessment, and cognitive-behavioral treatment of OCD and related conditions across the developmental spectrum. Dr. Franklin is Associate Professor Emeritus of Clinical Psychology in Psychiatry at the University of Pennsylvania School of Medicine and OCD Service Line Leader at Rogers Behavioral Health in Philadelphia. He has published over 260 scholarly articles, chapters, and books, lectured around the world on these and other topics, and has been awarded for teaching excellence three different times during his 20 years at Penn.
Target Audience
This presentation is intended for licensed mental health professionals and advanced graduate student trainees seeking licensure and with some clinical experience. The instructional level of this presentation is INTERMEDIATE.
Continuing Education
- Philadelphia Behavior Therapy Association is approved by the American Psychological Association to sponsor continuing education for psychologists*. Philadelphia Behavior Therapy Association maintains responsibility for this program and its content.
- This program provides one (3) hour of CE credits.
- PBTA is also an authorized provider of CE credits for Professional Counselors, Marriage and Family Therapists, and Clinical Social Workers licensed in the state of Pennsylvania.
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