Intensive Cognitive-Behavioral Therapy Telehealth for Pediatric Obsessive-Compulsive Disorder During the COVID-19 Pandemic: Comparison With a Matched Sample Treated in Person

Abstract

Objective

This naturalistic, nonblinded, nonrandomized study examined the efficacy of multimodal treatment including intensive cognitive-behavioral therapy (CBT) for pediatric obsessive-compulsive disorder (OCD) delivered via telehealth (TH) compared with a matched sample of youth treated in person (IP).

Method

Patients included 1,286 youth ages 7 to 17 inclusive (643 TH, 643 IP) who received TH or IP in either partial hospitalization (n = 818) or intensive outpatient (n = 468) programs. Changes in patient-rated OCD symptoms and quality of life from pretreatment to posttreatment were examined.

Results

TH patients were discharged with a statistically higher Children’s Yale-Brown Obsessive-Compulsive Scale Self-Report score than IP patients, although this group difference (1.4) was not clinically significant. Quality-of-life scores at discharge did not significantly differ between TH patients and IP patients. Treatment response was robust attesting to the broad applicability of the treatment model.

Conclusion

Youth receiving CBT via TH responded both well and comparably to youth treated IP, offering a viable access path forward. These findings extend the reach of CBT for pediatric OCD. Concerted efforts must now be made to improve CBT availability for families for whom financial, insurance, geographical, and other barriers preclude access at present.

Diversity & Inclusion Statement

We worked to ensure that the study questionnaires were prepared in an inclusive way. We worked to ensure sex and gender balance in the recruitment of human participants. We worked to ensure race, ethnic, and/or other types of diversity in the recruitment of human participants. We actively worked to promote sex and gender balance in our author group. While citing references scientifically relevant for this work, we also actively worked to promote sex and gender balance in our reference list. While citing references scientifically relevant for this work, we also actively worked to promote inclusion of historically underrepresented racial and/or ethnic groups in science in our reference list.