Many young children who suffer from obsessive-compulsive disorder may get better with the help of psychological therapy that involves their parents as well. Children as young as 3 have been diagnosed with obsessive-compulsive disorder, or OCD, an anxiety disorder in which people have persistent, intrusive thoughts that drive them to ritualistically perform certain actions. Someone with an obsessive fear of germs, for example, might wash his or her hands over and over throughout the day. In a young child, the same obsession might cause the child to repeatedly lick his or her hands. A form of psychological counselling called cognitive behavioural therapy, or CBT, is considered the most effective therapy for OCD. It teaches people to retrain their thought patterns and realise that they do not have to resort to their obsessive behaviours to calm their anxiety. However, few studies of CBT have included young children - those whose OCD symptoms arise before the age of 9. Children this young are likely to need a tailored form of CBT that they can understand, and that involves their parents as well. American researchers adapted the therapy into what they call family-based CBT. The goal was to give both young children and their parents the tools to deal with OCD. They looked at the effects of family-based CBT among 42, 5- to 8-year-olds with OCD. Some of the families were randomly assigned to 12 sessions of CBT, while the rest were assigned to family-based relaxation therapy. The goal of the family-based CBT was the same as that of therapy for adults and older children - to make the children realise they do not have to resort to a compulsive behaviour whenever they are in an anxiety-provoking situation. At the end of the study it was found that 69 percent of the children who completed all 14 weeks of treatment were in clinical remission - meaning their OCD symptoms had improved to the point that they no longer needed therapy. That compared with 20 percent of children who completed the relaxation therapy programme. Being a newer concept, family-based therapy for young children's OCD is not yet widely available.
Journal of the American Academy of Child and Adolescent Psychiatry
June 2008