Concentrated therapy for childhood OCD: what the Clínic study found

What they did

OCD affects approximately 1% of children and adolescents and can interfere substantially with daily life. Cognitive behavioural therapy with exposure and response prevention is a recommended treatment, but access and attendance over several months can be difficult for some families.

Researchers at Clínic-IDIBAPS, led by Dr Miquel A. Fullana and Dr Luisa Lázaro, with Dr Laura Hermida as first author, tested an alternative: the same therapy, concentrated. Twenty hours in total, in sessions of an hour and a half, spread over a maximum of four weeks.

Thirty children and adolescents aged 7 to 17 took part, none of them on medication, randomly assigned to the treatment group or to a waiting list.

What they found

• Symptoms dropped by an average of 30% on the scale used to measure childhood OCD (CY-BOCS).
• The improvement held at the three- and six-month follow-ups.
• The youngest responded best. Children aged 7 to 12 improved more than adolescents.
• Those who started worse had more room to improve.
• At the end of the study, the same treatment was offered to those on the waiting list, with very similar results.

What it means

The study shows that the team could deliver this protocol over four weeks and detect a reduction in symptoms compared with a waiting list. It did not compare concentrated treatment with the same amount of therapy distributed over several months, so it cannot show which is completed more often or which works better.

The analysis found a better average response among participants aged 7 to 12 than among adolescents. This was an exploratory finding in very small subgroups and needs replication; it does not show that treatment is ineffective in adolescence.

What it does NOT mean

• It isn't a new treatment. It's the same one — cognitive behavioural therapy with exposure and response prevention — delivered more intensively. There's no miracle pill and no revolutionary technique: there's a quicker format of what we already know works.
• It is not conclusive. Thirty young people took part and the comparison was a waiting list, not another active treatment. Larger trials need to compare formats and examine age-related results.
• It doesn't mean you can do it yourself. Concentrated therapy is therapy: it's delivered by professionals trained in OCD. Exposure done badly at home doesn't help; it can do harm.