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Clinical Case Studies, Vol. 5, No. 6,
511-521 (2006)
DOI: 10.1177/1534650106290373
The Principles of Extinction and Differential Reinforcement of Other Behaviors in the Intensive Cognitive-Behavioral Treatment of Primarily Obsessional Pediatric OCD
Melanie A. Fernandez
University of Florida
Eric A. Storch
University of Florida
Adam B. Lewin
University of Florida
Tanya K. Murphy
University of Florida
Gary R. Geffken
University of Florida
This case study describes the application of intensive cognitive-behavioral treatment (CBT), focusing on extinction and differential reinforcement of other behaviors (DRO), in an adolescent girl with primarily obsessional obsessive-compulsive disorder (OCD). "Abby," a 13-year-old, Caucasian female, showed meaningful changes in OCD symptomatology during five consecutive sessions of intensive treatment. Abbys mother also reported dramatic improvements in Abbys functioning and in the mother-child relationship. Improvements continued to be reported by Abby and her mother and observed by therapists during follow-up sessions. The results of this case study provide preliminary support that intensive CBT incorporating extinction, cognitive restructuring skills, and DRO may be an effective treatment for pediatric OCD.
Key Words: obsessive-compulsive disorder differential reinforcement of other behaviors cognitive-behavioral therapy treatment adolescent
References
- American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (4th ed., text revision). Washington, DC: Author.
- Barrett, P., Healy-Farrell, L., & March, J. S. (2004). Cognitive behavioral family treatment of childhood obsessive-compulsive disorder: A controlled trial. Journal of the American Academy of Child and Adolescent Psychiatry, 43, 46-62.[CrossRef][Medline]
[Order article via Infotrieve]
- Benazon, N. R., Ager, J., & Rosenberg, D. R. (2002). Cognitive behavior therapy in treatment-naïve children and adolescents with obsessive-compulsive disorder: An open trial. Behaviour Research and Therapy, 40, 529-539.[CrossRef][Medline]
[Order article via Infotrieve]
- de Haan, E., Hoogduin, K. A. L., Buitelaar, J. K., & Keijsers, G. P. J. (1998). Behavior therapy versus clomipramine for the treatment of obsessive-compulsive disorder. Journal of the American Academy of Child and Adolescent Psychiatry, 37, 1022-1029.[CrossRef][Medline]
[Order article via Infotrieve]
- Francis, G. (1988). Childhood obsessive-compulsive disorder: Extinction of compulsive reassurance-seeking. Journal of Anxiety Disorders, 2, 361-368.
- Franklin, M. E., & Foa, E. B. (2002). Cognitive behavioral treatments for obsessive compulsive disorder. In P. E. Nathan & J. M. Gorman (Eds.), A guide to treatments that work (2nd ed., pp. 367-386). London: Oxford University Press.
- Franklin, M. E., Kozak, M. J., Cashman, L. A., Coles, M. E., Rheingold, A., & Foa, E. B. (1998). Cognitive-behavioral treatment of pediatric obsessive-compulsive disorder: An open clinical trial. Journal of the American Academy of Child and Adolescent Psychiatry, 37, 412-419.[CrossRef][Medline]
[Order article via Infotrieve]
- Franklin, M. E., Tolin, D. F., March, J. S., & Foa, E. B. (2001). Treatment of pediatric obsessive-compulsive disorder: A case example of intensive cognitive-behavioral therapy involving exposure and ritual prevention. Cognitive and Behavioral Practice, 8, 297-304.
- Knox, L. S., Albano, A. M., & Barlow, D. H. (1996). Parental involvement in the treatment of childhood obsessive compulsive disorder: a multiple baseline examination incorporating parents. Behavior Therapy, 27, 93-115.[CrossRef]
- March, J. S., & Mulle, K. (1998). OCD in children and adolescents: A cognitive-behavioral treatment manual. New York: Guilford.
- March, J. S., Parker, J. D., Sullivan, K., Stallings, P., & Conners, C. K. (1997). The Multidimensional Anxiety Scale for Children (MASC): Factor structure, reliability, and validity. Journal of the American Academy of Child and Adolescent Psychiatry, 36, 554-565.[CrossRef][Medline]
[Order article via Infotrieve]
- Pediatric Obsessive-Compulsive Disorder Treatment Study (POTS) Team. (2004). Cognitive-behavioral therapy, sertraline, and their combination for children and adolescents with obsessive-compulsive disorder: The Pediatric Obsessive-Compulsive Disorder Treatment Study (POTS) Randomized Controlled Trial. Journal of the American Medical Association, 292, 1969-1976.[Abstract/Free Full Text]
- Piacentini, J., Bergman, R. L., Jacobs, C., McCracken, J. T., & Kretchman, J. (2002). Open trial of cognitive behavior therapy for childhood obsessive-compulsive disorder. Journal of Anxiety Disorders, 16, 207-219.[CrossRef][Medline]
[Order article via Infotrieve]
- Piacentini, J., Bergman, R. L., Keller, M., & McCracken, J. (2003). Functional impairment in children and adolescents with obsessive-compulsive disorder. Journal of Child and Adolescent Psychopharmacology, 13S-1, S61-S69.[CrossRef]
- Rapoport, J., Inoff-Germain, G., Weissman, M., Greenwald, S., Narrow, W., Jensen, P., et al. (2000). Childhood obsessive-compulsive disorder in the NIMH MECA Study: Parent versus child identification of cases. Journal of Anxiety Disorders, 14, 535-548.[CrossRef][Medline]
[Order article via Infotrieve]
- Salkovskis, P. M. (1999). Understanding and treating obsessive-compulsive disorder. Behavior Research and Therapy, 37, S29-S52.
- Scahill, L., Kano, Y., King, R. A., Carlson, A., Peller, A., LeBrun, U., et al. (2003). Influence of age and tic disorders on obsessive-compulsive disorder in a pediatric sample. Journal of Child and Adolescent Psychopharmacology, 13S-1, S7-S17.
- Scahill, L., Riddle, M., McSwiggin-Hardin, M., Ort, S., King, R., Goodman, W., et al. (1997). Childrens Yale-Brown Obsessive-Compulsive Scale: Reliability and validity. Journal of the American Academy of Child and Adolescent Psychiatry, 36, 844-852.[CrossRef][Medline]
[Order article via Infotrieve]
- Simonds, L. M., & Elliot, S. A. (2001). OCD patients and non-patient groups reporting obsessions and compulsions: Phenomenology, help-seeking, and access to treatment. British Journal of Medical Psychology, 74, 431-449.[CrossRef][Medline]
[Order article via Infotrieve]
- Storch, E. A., & Geffken, G. R. (2003, November). Intensive cognitive behavior therapy for pediatric obsessive-compulsive disorder. Symposium presented at the annual meeting of the Anxiety Disorders Association of America, Miami.
- Storch, E. A., Gelfand, K. M., Geffken, G. R., & Goodman, W. K. (2003). An intensive outpatient approach to the treatment of obsessive-compulsive disorder: Case exemplars. Annals of the American Psychotherapy Association, 4, 14-19.
- Storch, E. A., Gerdes, A., Atkins, J., Geffken, G. R., Star, J., & Murphy, T. (2004). Behavioral treatment of child with pediatric autoimmune neuropsychiatric disorder associated with group a streptococcal infection. Journal of the American Academy of Child and Adolescent Psychiatry, 43, 510-511.[CrossRef][Medline]
[Order article via Infotrieve]
- Thomsen, P. H. (1994). Obsessive-compulsive disorder in children and adolescents: A 6-22 year follow-up study: Clinical descriptions of the course and continuity of obsessive-compulsive symptomatology. European Child and Adolescent Psychiatry, 3, 82-96.[CrossRef]
- Thomsen, P. H., & Mikkelsen, H. U. (1995). Course of obsessive-compulsive disorder in children and adolescents: A prospective follow-up study of 23 Danish cases. Journal of the American Academy of Child and Adolescent Psychiatry, 34, 1432-1440.[CrossRef][Medline]
[Order article via Infotrieve]
- Zohar, A. H. (1999). The epidemiology of obsessive-compulsive disorder in children and adolescents. Child and Adolescent Psychiatric Clinics of North America, 8, 445-460.[Medline]
[Order article via Infotrieve]

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