The role of treatment expectancy in youth receiving exposure-based CBT for obsessive compulsive disorder☆,
Highlights
► We examined child, parent, and therapist expectancy for CBT for OCD. ► Increased child/therapist expectation correlated with greater improvement after CBT. ► Higher expectancy was linked to lower attrition and better homework compliance. ► Lower expectations were found in youth with depressive or externalizing symptoms. ► Pre-treatment OCD severity did not lower expectations for CBT.
Section snippets
Participants
Our sample consisted of 71 youth with OCD and their parents who participated in a randomized controlled treatment trial (registered on clinical trials.gov #NCT00000386) conducted at a university medical center-based OCD specialty program (Piacentini et al., under review). The current study focused on 49 youth (59% male) who received exposure-based CBT and the demographic data below correspond to these youth. Mean age for the sample was twelve years (SD = 2.6 years, range = 8–17 years) with an
Evaluation of study hypotheses
Are higher levels of OCD-symptom severity and functional impairment associated with lower expectations of treatment? Child ratings of OCD-specific functional impairment were negatively correlated with child and therapist expectancies. Expectancy was not correlated with baseline OCD severity. Data are presented in Table 1.
Are higher levels of comorbidity associated with reduced treatment expectations? Higher child-rated symptoms of depression (at baseline) were associated with lower expectancy
Discussion
The present investigation examined clinical and demographic correlates of parent, child, and therapist treatment expectations and links between expectancies and treatment outcome for youth receiving CBT for OCD. We hypothesized that higher levels of child OCD-symptom severity, comorbidity, parental OCD, and prior OCD treatment would be associated with lower expectations of treatment for all three respondents. As expected, parents endorsing their own OCD symptoms had lower expectations of their
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2023, Psychiatry Research CommunicationsThe relationship between homework adherence and outcome in family-based cognitive-behavioral therapy for early-onset obsessive compulsive disorder
2022, Journal of Obsessive-Compulsive and Related DisordersCitation Excerpt :Moreover, there does not currently exist a widely used, standardized measure of treatment homework completed outside of session (Mausbach, Moore, Roesch, Cardenas, & Patterson, 2010; Wheaton & Chen, 2021). Many past studies have measured this construct using clinician-rated Likert-type scales (e.g., Lewin, Peris, Bergman, McCracken, & Piacentini, 2011; Selles et al., 2018), although a few studies have used patient-report data (e.g., Westra, Dozois, & Marcus, 2007), and a few have used objective measures such as the number of homework assignments turned in (e.g., Woods, Chambless, & Steketee, 2002). In this study, we opt to use the term “homework adherence” rather than “homework compliance” to more clearly acknowledge the existence of barriers to homework completion and reduce undue emphasis on the motivation of patients and families.
Longitudinal trajectory and predictors of change in family accommodation during exposure therapy for pediatric OCD
2021, Journal of Anxiety Disorders
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This research was conducted at the UCLA Semel Institute, 760 Westwood Plaza, Los Angeles, CA 90024, USA.
This research was funded by: NIMH R01MH 58459 (Piacentini), NIMH T-32 Fellowships (Lewin, Peris), grants from the Joseph Drown Foundation & Friends of the Semel Institute Fellowship (Lewin), NARSAD Young Investigator Awards (Lewin, Peris), and NIMH K23 MH085058 (Peris).