Increasing access to Cognitive Behavioural Therapy (CBT) for preadolescent children with Obsessive Compulsive Disorder (OCD)

Childhood Obsessive Compulsive Disorder (OCD) has a mean age of onset of 10.5-years, affects up to 3% of preadolescent children internationally, and is ranked one of the top 10 most debilitating disorders by the World Health Organisation. Cognitive Behavioural Therapy (CBT) including Exposure and Response Prevention (ERP) is an effective psychological treatment for childhood OCD, however existing treatments are lengthy (i.e., >10-hours of therapist support) and require delivery by specialists, substantially limiting the number of children who can benefit.

Indeed, in the UK, parents of preadolescent children with OCD have reported waiting over 2-years for their child to receive CBT. The development of a brief, online therapist-supported, parent-led CBT intervention (i.e., ~ 2.5-hours of therapist support) has the potential to substantially increase access to CBT for preadolescent children with OCD. This approach has been shown to be effective and cost-effective for children with anxiety problems, even when delivered by non-specialist therapists.

This project aims to ultimately increase access to CBT for preadolescent children with OCD by adapting an existing brief online therapist-supported, parent-led CBT intervention for children with anxiety problems (called OSI - Online Support and Intervention) for families of preadolescent children with OCD that can be delivered by an existing (and continually growing) UK workforce of non-specialist therapists. Specifically, this project aims to:

Work with key stakeholders (i.e., parents and children with lived experience of OCD, charity representatives, and clinicians) to co-adapt OSI for anxiety difficulties to ensure suitability for families of preadolescent children with OCD and supporting clinicians.

Conduct a feasibility randomised controlled trial (RCT) comparing OSI for OCD to usual treatment in child mental health services to determine the feasibility of (a) the novel intervention, and (b) a definitive RCT comparing the clinical outcomes and cost-effectiveness of OSI for OCD to usual treatment in child mental health services.

Conduct a process evaluation to explore (a) the implementation and acceptability, (b) mechanisms of impact, and (c) contextual factors that affect delivery, engagement, and outcomes for OSI for OCD to optimise the design of a future definitive RCT and subsequent wider implementation of OSI for OCD, if indicated.