Cognitive-behavioral treatment of childhood obsessive-compulsive disorder in community-based clinical practice: clinical significance and benchmarking against efficacy

Objective: To evaluate the feasibility and outcomes of evidence-based (EB) manualized, cognitive behavioral treatment (CBT) for childhood obsessive compulsive disorder (OCD), when delivered in an outpatient community-based specialist clinic. Method: This study, conducted in an outpatient private clinic in South-East Queensland Australia, involved thirty-three children and adolescents with OCD. Children were assessed at pre- and post-treatment, by means of diagnostic interviews, symptom severity interviews, and self-report. Treatment involved 12 sessions CBT delivered either individually or in small groups and included parental involvement. Results: Manualized CBT could be transported to the community setting effectively, with 63% of the current sample responding positively, based on post-treatment diagnosis. Significant change was evident across a wide-range of outcomes; including, diagnostic severity, symptom severity, child reported depression and anxiety, and both child and parent reported OCD functional impairment. Conclusions: This study provides evidence for the transportability of manualized CBT in clinical community practice for pediatric OCD. The next important step is larger community based dissemination and effectiveness studies to advance both research and clinical practice outcomes. (c) 2010 Elsevier Ltd. All rights reserved.