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Vol. 20 no. 2
ordering compulsions. Total difficul-
ties scores were no greater by self-report
or teacher-report and the two groups
were similar in terms of family history
of OCD, symptom severity, depres-
sion, and psychosocial disability. Both
the very early onset group and the
late onset group reported significant
reductions in OCD symptoms over the
course of intervention via CBT.
Christian counselors may be
encouraged to see that, at least in this
study, while there may be differences
between children with early and late
onset OCD, the responsiveness to treat-
ment is not tied to onset. Both groups
of children responded “equally well to
CBT that is tailored to their develop-
mental level” (p. 1,267). The research-
ers encourage accurate early detection
and intervention of OCD followed by
evidence-based interventions.
Predicting Quality of Life in
Children with OCD
Palermo, S.D., Bloch, M.H., Craiglow, B.,
Landeros-Weisenberger, A., Dombrowski,
P.A., Panza, K., Smith, M.E., Peterson, B.S.
& Leckman, J.F. (2011). Predictors of Early
Adulthood Quality of Life in Children with
Obsessive-Compulsive Disorder.
Social
Psychiatry and Psychiatric Epidemiology
, 46,
291-297. DOI: 10.1007/s00127-010-0194-2.
Sean Palermo and his colleagues con-
ducted a study to identify predictors of
quality of life in early adulthood among
children diagnosed with obsessive-
compulsive disorder (OCD). This was a
longitudinal study with completed data
from 36 children (out of a possible 61)
with OCD. The children were inter-
viewed at a baseline (average age of 12
years) and again in emerging adulthood,
at an average age of 21 (nine years later).
Fifteen participants (42%) experi-
enced a remission of OCD symptoms
by early adulthood. Another 14 (39%)
reported minimal OCD, while five
(14%) had moderate OCD and two
(6%) had severe OCD. More than half
(57%) had no evidence of impaired
quality of life in adulthood. Primary
hoarding OCD symptoms at initial
assessment in childhood predicted lower
quality of life in emerging adulthood.
Among those whose OCD symptoms
did not remit, the greatest impairments
were noted in the interpersonal relation-
ships and work/employment domains
(though in the mild range, on average).
The researchers see their findings as
providing hope for families insofar as
children initially diagnosed with OCD
were often functioning well in adult-
hood. This was true even when OCD
symptoms did not completely remit.
Other comorbid conditions, such as
ADHD, tic disorders, and depression
did not predict quality of life in emerg-
ing adulthood.
Mother-Child Interactions
and Childhood OCD
Schlup, B., Farrell, L. & Barrett, P. (2013).
Mother-Child Interactions and Childhood
OCD: Effects of CBT on Mother and
Child Observed Behaviors.
Child & Family
Behavior Therapy
, 33 (4), 322-336. DOi:
10.1080/07317107.2011.623920.
Barbara Schlup and her colleagues
studied a group-based cognitive behav-
ioral therapy with family focus (CBT-
F) for the treatment of children with
obsessive-compulsive disorder (OCD).
Participants were 44 children and ado-
lescents ranging in age from seven to 17
years (M = 12.05, SD = 2.84) diag-
nosed with OCD and their mothers.
Participants were randomly assigned
to either the treatment condition or a
wait list control group—25 were in the
CBT-F treatment group, while 19 were
in the control group. Most participants
(80%) met criteria for a secondary diag-
nosis, including Generalized Anxiety
Disorder (34%), Separation Anxiety
Disorder (16%), Social Phobia (14%),
Specific Phobia (9%), and Major
Depression (5%).
The CBT-F intervention consisted
of 14 weekly, 90-minute group sessions
divided up as follows: 50 minutes of
group CBT with children (psychoedu-
cation, anxiety management, graded
exposure/response prevention, etc.); 30
minutes of parent skills training (psy-
choeducation, problem-solving, etc.);
and 10 minutes of family review of
progress in treatment.
There were no significant differ-
ences between the CBT-F treatment
group and control group on age, pres-
ence of comorbidity, gender, or mother/
child behavioral variables; however,
there were differences in OCD sever-
ity at the beginning of treatment, with
the CBT-F participants being less severe
pretreatment. For all subsequent analy-
ses, pretreatment symptom severity was
entered as a covariate.
Both mother-observed behaviors
and child-observed behaviors were over-
all more positive after CBT-F treatment
as compared to the wait list control
group. The results suggest that CBT
with family involvement “may help to
improve mother-child behavioral inter-
actions in families with a child suffering
from OCD” (p. 332). Because of design
limitations, it is also possible that symp-
tom improvement lead to better family
interactions.
Christian counselors are certainly
seeing more research on interventions
that include family members in the
treatment of childhood OCD. There
appears to be growing evidence that
involving family is helpful, and this
study provides some preliminary sup-
port for that understanding.
✠
Mark A. Yarhouse,
Psy.D.,
is the Rosemarie
Scotti Hughes Chair
of Christian Thought in
Mental Health Practice and
Professor of Psychology
at Regent University, where he directs the
Institute for the Study of Sexual Identity
(sexualidentityinstitute.org). He is author or
co-author of several books, including
Homosexuality and the Christian: A Guide
for Parents, Pastors, and Friends
.
