An Initial Case Series of Intensive Cognitive–Behavioral Therapy for Obsessive–Compulsive Disorder in Adolescents with Autism Spectrum Disorder
Obsessive–compulsive disorder (OCD) is prevalent among youth with autism spectrum disorder (ASD). Cognitive–behavioral therapy (CBT) with ASD-specific modifications has support for treating OCD in this population; however, use of intensive CBT in youth with ASD and severe OCD has not been tested. The current study examined the preliminary effectiveness of an individualized intensive CBT protocol for OCD in adolescents with ASD. Nine adolescents (aged 11–17 years) completed a regimen of intensive CBT (range 24–80 daily sessions) incorporating exposure with response prevention (ERP). Treatment materials, language and techniques were modified in accordance with evidence-based findings for this population. Seven of nine participants (78%) were treatment responders, and large treatment effects (d = 1.35–2.58) were obtained on primary outcomes (e.g., obsessive–compulsive symptom severity). Preliminary findings suggest that an intensive CBT approach for OCD is effective among adolescents with ASD.
KeywordsObsessive–compulsive disorder Autism spectrum disorders Cognitive–behavioral therapy Intensive treatment Adolescents
The Funding for preparation this manuscript was provided to the first author by Ministry of Education, Culture and Sports of Spanish Government in the “José Castillejo” Program, Grant CAS15/00381. Ministry of Education, Culture and Sports had no role in the study, or the decision to submit the paper for publication.
- 2.Centers for Disease Control and Prevention. (2014) Prevalence of autism spectrum disorder among children aged 8 years: autism and developmental disabilities monitoring network. MMWR Surveill Summ 63:1–21Google Scholar
- 10.McGuire JF, Piacentini J, Lewin AB, Brennan EA, Murphy TK, Storch EA (2015) A meta-analysis of cognitive behavior therapy and medication for child obsessive–compulsive disorder: moderators of treatment effectiveness, response, and remission. Depress Anxiety 32:580–593CrossRefPubMedPubMedCentralGoogle Scholar
- 12.Geller DA, Biederman J, Stewart SE, Mullin B, Farrell C, Wagner KD (2003) Impact of comorbidity on treatment response to paroxetine in pediatric obsessive–compulsive disorder: is the use of exclusion criteria empirically supported in randomized clinical trials? J Child Adolesc Psychopharmacol 13:19–29CrossRefGoogle Scholar
- 51.NIMH (1985) Rating scales and assessment instruments for use in pediatric psychopharmacology research. Psychopharmacol Bull 21:839–843Google Scholar
- 55.Storch EA, Arnold EB, Lewin AB, Nadeau JM, Jones AM, De Nadai AS et al (2013) The effect of cognitive–behavioral therapy versus treatment as usual for anxiety in children with autism spectrum disorders: a randomized, controlled trial. J Am Acad Child Adolesc Psychiatry 52:132–142CrossRefPubMedGoogle Scholar
- 59.Storch EA, Lehmkuhl HD, Ricketts E, Geffken GR, Marien W, Murphy TK (2010) An open trial of intensive family based cognitive–behavioral therapy in youth with obsessive–compulsive disorder who are medication partial responders or nonresponders. J Clin Child Adolesc Psychol 39:260–268CrossRefPubMedGoogle Scholar