Ideal Treatment Package for Children and Adolescents with Anger Disorders

BACKGROUND Although the evidence base of cognitive behavioral therapy (CBT) for pediatric obsessive-compulsive disorder (OCD) has been broadly established, the treatment is hampered by limited access, poor compliance, and nonresponse. New technologies offer the opportunity to improve the accessibility, user friendliness, and effectiveness of traditional office-based CBT. By employing an integrated and age-appropriate technologically enhanced treatment package, we aim to execute a more focused and attractive application of CBT principles to increase the treatment effect for pediatric OCD. OBJECTIVE The aim of this open study is to explore the acceptability, feasibility, and effectiveness of a newly developed enhanced CBT (eCBT) package for pediatric OCD. METHODS This study is an open trial using a historical control design conducted at the outpatient clinic of the Department of Child and Adolescent Psychiatry at St. Olavs University Hospital (Trondheim) or at BUP Klinikk (Aalesund). Participants are 30 children (age 7-17 years) with a primary Diagnostic and Statistical Manual of Mental Disorders (DSM)-5 diagnosis of OCD, and their parents. All participants receive eCBT. eCBT consists of the usual evidence-based CBT for pediatric OCD in an “enhanced” format. Enhancements include videoconferencing sessions (supervision and guided exposure exercises at home) in addition to face-to-face sessions; an app system of interconnected apps for the child, the parents, and the therapist; psychoeducative videos; and frequent online self-assessments with direct feedback to patients and the therapist. Primary outcome measures are the Children’s Yale-Brown Obsessive Compulsive Scale (CY-BOCS) (effectiveness), the Client Satisfaction Questionnaire-8 (acceptability), and treatment drop out (feasibility). Assessments are conducted pretreatment, posttreatment, and at 3- and 6-month follow-ups. A 12-month follow-up assessment is envisioned. The treatment outcome (CY-BOCS) will be compared to traditional face-to-face CBT (data collected in the Nordic Long-term OCD Treatment Study). RESULTS Ethical approval has been obtained (2016/716/REK nord). Inclusion started on September 04, 2017. Data collection is ongoing. CONCLUSIONS This study is the first step in testing the acceptability, feasibility, and preliminary effectiveness of eCBT. In case of positive results, future steps include improving the eCBT treatment package based on feedback from service users, examining cost-effectiveness in a randomized controlled trial, and making the package available to clinicians and other service providers treating OCD in children and adolescents. CLINICALTRIAL ISRCTN, ISRCTN37530113; registered on January 31, 2020 (retrospectively registered); https://www.isrctn.com/ISRCTN37530113. INTERNATIONAL REGISTERED REPORT DERR1-10.2196/24057

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Feasibility, Acceptability, and Effectiveness of Enhanced Cognitive Behavioral Therapy (eCBT) for Children and Adolescents With Obsessive-Compulsive Disorder: Protocol for an Open Trial and Therapeutic Intervention

JMIR Research Protocols ◽

10.2196/24057 ◽

2020 ◽

Vol 9 (12) ◽

pp. e24057

Author(s):

Lidewij H Wolters ◽

Bernhard Weidle ◽

Lucía Babiano-Espinosa ◽

Norbert Skokauskas

Keyword(s):

Cognitive Behavioral Therapy ◽

Children And Adolescents ◽

Obsessive Compulsive Disorder ◽

Behavioral Therapy ◽

Cognitive Behavioral ◽

Obsessive Compulsive ◽

Face To Face ◽

Compulsive Disorder ◽

Pediatric Ocd ◽

Treatment Package

Background Although the evidence base of cognitive behavioral therapy (CBT) for pediatric obsessive-compulsive disorder (OCD) has been broadly established, the treatment is hampered by limited access, poor compliance, and nonresponse. New technologies offer the opportunity to improve the accessibility, user friendliness, and effectiveness of traditional office-based CBT. By employing an integrated and age-appropriate technologically enhanced treatment package, we aim to execute a more focused and attractive application of CBT principles to increase the treatment effect for pediatric OCD. Objective The aim of this open study is to explore the acceptability, feasibility, and effectiveness of a newly developed enhanced CBT (eCBT) package for pediatric OCD. Methods This study is an open trial using a historical control design conducted at the outpatient clinic of the Department of Child and Adolescent Psychiatry at St. Olavs University Hospital (Trondheim) or at BUP Klinikk (Aalesund). Participants are 30 children (age 7-17 years) with a primary Diagnostic and Statistical Manual of Mental Disorders (DSM)-5 diagnosis of OCD, and their parents. All participants receive eCBT. eCBT consists of the usual evidence-based CBT for pediatric OCD in an “enhanced” format. Enhancements include videoconferencing sessions (supervision and guided exposure exercises at home) in addition to face-to-face sessions; an app system of interconnected apps for the child, the parents, and the therapist; psychoeducative videos; and frequent online self-assessments with direct feedback to patients and the therapist. Primary outcome measures are the Children’s Yale-Brown Obsessive Compulsive Scale (CY-BOCS) (effectiveness), the Client Satisfaction Questionnaire-8 (acceptability), and treatment drop out (feasibility). Assessments are conducted pretreatment, posttreatment, and at 3- and 6-month follow-ups. A 12-month follow-up assessment is envisioned. The treatment outcome (CY-BOCS) will be compared to traditional face-to-face CBT (data collected in the Nordic Long-term OCD Treatment Study). Results Ethical approval has been obtained (2016/716/REK nord). Inclusion started on September 04, 2017. Data collection is ongoing. Conclusions This study is the first step in testing the acceptability, feasibility, and preliminary effectiveness of eCBT. In case of positive results, future steps include improving the eCBT treatment package based on feedback from service users, examining cost-effectiveness in a randomized controlled trial, and making the package available to clinicians and other service providers treating OCD in children and adolescents. Trial Registration ISRCTN, ISRCTN37530113; registered on January 31, 2020 (retrospectively registered); https://www.isrctn.com/ISRCTN37530113. International Registered Report Identifier (IRRID) DERR1-10.2196/24057

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Analyzing the Potential Benefit of Microcomputer Use for Teaching Figurative Language

American Journal of Speech-Language Pathology ◽

10.1044/1058-0360.0102.36 ◽

1992 ◽

Vol 1 (2) ◽

pp. 36-43 ◽

Cited By ~ 5

Author(s):

Marilyn A. Nippold ◽

Ilsa E. Schwarz ◽

Molly Lewis

Keyword(s):

Language Learning ◽

Children And Adolescents ◽

Standardized Tests ◽

Figurative Language ◽

Language Intervention ◽

School Age Children ◽

Educational Materials ◽

Language Learning Disabilities ◽

Promising Application ◽

Experience Difficulty

Microcomputers offer the potential for increasing the effectiveness of language intervention for school-age children and adolescents who have language-learning disabilities. One promising application is in the treatment of students who experience difficulty comprehending figurative expressions, an aspect of language that occurs frequently in both spoken and written contexts. Although software is available to teach figurative language to children and adolescents, it is our feeling that improvements are needed in the existing programs. Software should be reviewed carefully before it is used with students, just as standardized tests and other clinical and educational materials are routinely scrutinized before use. In this article, four microcomputer programs are described and evaluated. Suggestions are then offered for the development of new types of software to teach figurative language.

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Using Video Modeling Intervention and Speech Generating Devices To Teach Requesting Behaviors to Persons With Autism

Perspectives on Augmentative and Alternative Communication ◽

10.1044/aac20.4.109 ◽

2011 ◽

Vol 20 (4) ◽

pp. 109-113

Author(s):

Karen Copple ◽

Rajinder Koul ◽

Devender Banda ◽

Ellen Frye

Keyword(s):

Developmental Disabilities ◽

Experimental Design ◽

Communication Skills ◽

Observational Learning ◽

Video Modeling ◽

Single Subject ◽

Design Studies ◽

Communicative Behaviors ◽

Speech Generating Device ◽

Treatment Package

Abstract One of the instructional techniques reported in the literature to teach communication skills to persons with autism is video modeling (VM). VM is a form of observational learning that involves watching and imitating the desired target behavior(s) exhibited by the person on the videotape. VM has been used to teach a variety of social and communicative behaviors to persons with developmental disabilities such as autism. In this paper, we describe the VM technique and summarize the results of two single-subject experimental design studies that investigated the acquisition of spontaneous requesting skills using a speech generating device (SGD) by persons with autism following a VM intervention. The results of these two studies indicate that a VM treatment package that includes a SGD as one of its components can be effective in facilitating communication in individuals with autism who have little or no functional speech.

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