Manual-Driven group cognitive-behavioral therapy for adolescents with obsessive-compulsive disorder: a pilot study.
OBJECTIVE
Concerns about isolation, compromised development, partial pharmacotherapy response, therapist scarcity, and inadequate cognitive-behavioral therapy (CBT) adherence led the authors to adapt a CBT protocol to a group format for adolescents with obsessive-compulsive disorder (OCD). A naturalistic, open trial of group CBT for adolescent OCD is described. The authors predicted symptom improvement and format acceptability.


METHODS
Over a 1 -year period, 18 adolescents aged 13 to 17 years with OCD received 14-week group CBT based on March and Mulle's OCD in Children and Adolescents: A Cognitive-Behavioral Treatment Manual in four consecutive sessions of five to nine patients. Eighty-three percent had undergone at least one medication trial, and 78% had previous CBT experience.


RESULTS
OCD symptoms measured by the Children's Yale-Brown Obsessive Compulsive Scale improved significantly, both statistically and clinically. Adolescents consistently shared information and designed exposure interventions for themselves and others during sessions. Repeated self-report measures confirmed adolescents' satisfaction with therapy.


CONCLUSIONS
This pilot study demonstrates that a manual-based treatment protocol may be exported for clinical use, adaptable for the end-user's needs, and palatable to adolescent patients. Clinical improvement and patient satisfaction justify further investigation in a controlled study.
Thienemann
M
M
Division of Child and Adolescent Psychiatry and Child Development, Stanford University School of Medicine, Stanford, CA 94305, USA. mthiene@stanford.edu
Martin
J
J
Cregger
B
B
Thompson
H B
HB
Dyer-Friedman
J
J
D000293:Adolescent; D015928:Cognitive Behavioral Therapy; D005260:Female; D006801:Humans; D008297:Male; D008370:Manuals as Topic; D009771:Obsessive-Compulsive Disorder / Q000175:diagnosis / Q000523:psychology / Q000628:therapy*; D010043:Outcome and Process Assessment, Health Care; D010379:Peer Group; D010552:Personality Assessment; D011615:Psychotherapy, Group; D012934:Social Isolation