Internet-based cognitive behavior therapy for obsessive compulsive disorder: A pilot study

<p>Abstract</p> <p>Background</p> <p>Cognitive behavior therapy (CBT) is widely regarded as an effective treatment for obsessive compulsive disorder (OCD), but access to CBT therapists is limited. Internet-based CBT (ICBT) with therapist support is a way to increase access to CBT but has not been developed or tested for OCD. The aim of this study was to evaluate ICBT for OCD.</p> <p>Method</p> <p>An open trial where patients (N = 23) received a 15-week ICBT program with therapist support consisting of psychoeducation, cognitive restructuring and exposure with response prevention. The primary outcome was the Yale-Brown Obsessive Compulsive Scale (Y-BOCS), which was assessed by a psychiatrist before and immediately after treatment. Secondary outcomes were self-rated measures of OCD symptoms, depressive symptoms, general functioning, anxiety and quality of life. All assessments were made at baseline and post-treatment.</p> <p>Results</p> <p>All participants completed the primary outcome measure at all assessment points. There were reductions in OCD symptoms with a large within-group effect size (Cohen's <it>d </it>= 1.56). At post-treatment, 61% of participants had a clinically significant improvement and 43% no longer fulfilled the diagnostic criteria of OCD. The treatment also resulted in statistically significant improvements in self-rated OCD symptoms, general functioning and depression.</p> <p>Conclusions</p> <p>ICBT with therapist support reduces OCD symptoms, depressive symptoms and improves general functioning. Randomized trials are needed to confirm the effectiveness of this new treatment format.</p> <p>Trial Registration</p> <p>ClinicalTrials.gov: <a href="http://www.clinicaltrials.gov/ct2/show/NCT01348529">NCT01348529</a></p

Helping Parents Generalize PCIT Skills to Manage ASD-Related Behaviors: Handouts and Clinical Applications

This chapter will provide several handouts for parents to help tailor Parent-Child Interaction Therapy (PCIT) skills to manage autism spectrum disorder (ASD)-related behaviors (e.g., repetitive play, sensory dysregulation, insistence on sameness, poor social skills). Handouts cover how to manage ASD-related behaviors within the context of PCIT’s two phases: Child-Directed Interaction (CDI) and Parent-Directed Interaction (PDI). The chapter will additionally provide strategies for clinicians to help parents generalize skill acquisition to the home (e.g., additional considerations for setting up Special Time practice) and community environments (e.g., using CDI skills throughout the day). This chapter and the accompanying parent handouts aim to provide information for clinicians to best support families of children with ASD in generalizing these skills to manage ASD-related behaviors