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17 - Cognitive behavioural psychotherapy for obsessive compulsive disorders

Published online by Cambridge University Press:  21 August 2009

By
John S. March ,
Martin Franklin  and
Edna Foa
Edited by
Philip J. Graham
John S. March
Affiliation:
Duke University Medical Center, Durham, North Carolina, USA
Martin Franklin
Affiliation:
University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, USA
Edna Foa
Affiliation:
University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, USA
Philip J. Graham
Affiliation:
Institute of Child Health, University College London
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Summary

Introduction

At any given time, between 0.5% and 1% of children and adolescents suffer from clinically significant obsessive compulsive disorder (OCD) (Flament et al., 1988). Among adults with OCD, one-third to one-half develop the disorder during childhood or adolescence (Rasmussen and Eisen, 1990). Although some children persevere in the face of OCD, the disorder typically disrupts academic, social and vocational functioning. Hence, besides reducing morbidity associated with paediatric OCD, improvements in treating the disorder early in life have the potential to reduce adult morbidity.

Over the past 15 years, cognitive behavioral therapy (CBT) has emerged as the initial treatment of choice for OCD across the lifespan (March et al., 1997). Unlike other psychotherapies that have been applied, usually unsuccessfully, to OCD (March and Leonard, 1996), there is a logically consistent and compelling relationship between CBT, the disorder and the specified outcome (Foa and Kozak, 1991). Despite expert consensus that CBT is by far the best psychosocial treatment, clinicians routinely complain that patients will not comply with behavioural treatments and parents routinely complain that clinicians are poorly trained in CBT. Coupled with the lack of CBT-trained clinicians, the result is that many if not most children and adolescents are denied access to effective CBT. This unfortunate situation may be avoidable, given an increased understanding regarding the implementation of CBT in children and adolescents with OCD.

Type
Chapter
Information
Cognitive Behaviour Therapy for Children and Families , pp. 281 - 299
Publisher: Cambridge University Press
Print publication year: 2004

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References

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