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OCD in Children and Adolescents
A Cognitive-Behavioral Treatment Manual

John S. March and Karen Mulle
Foreword by Edna B. Foa

This practical manual presents a cognitive-behavioral treatment program that has been proven effective in eliminating or alleviating OCD symptoms in children across a broad range of ages and aptitudes. Building upon and expanding their internationally acclaimed How I ran OCD Off My Land, the authors provide an empirically grounded guide to assessment, treatment planning, and skills-based intervention. Clinicians are taken through the four stages of treatment--psychoeducation, cognitive training, mapping OCD, and graded exposure and response prevention--in 13 to 20 clearly structured treatment sessions. The book is enriched by sample dialogues, "clinical pearls" drawn from the authors' own experience, and appendices featuring reproducible rating scales, patient handouts, and tips and resources for parents.
 

Contents

Foreword, Foa
I. Introduction
1. Review of Pediatric OCD
2. Assessing OCD
3. Overview of Treatment
II. Session-by-Session Treatment Program
4. Session 1: Establishing a Neurobehavioral Framework
5. Session 2: Introducing the "Tool Kit"
6. Session 3: Mapping OCD
7. Session 4: Completing the Tool Kit
8. Session 5: Putting E/RP into Action
9. Session 6: E/RP Continues
10. Session 7: Family Session
11. Sessions 8--11: Moving Up the Stimulus Hierarchy
12. Session 12: Family Session II
13. Sessions 13--18: Completing E/RP
14. Session 19: Relapse Prevention
15. Session 20: Graduation
16. Session 21: Booster Session
III. Troubleshooting
17. Pitfalls
18. Special Wrinkles: Supplemental Treatment Interventions
19. Working with Families
20. Working with Schools (with Gail Adams)
Appendix I: Handouts and Figures
* Your CBT Program
* Map Figure
* Fear Thermometer
* Symptom List (Stimulus Hierarchy)
* Homework Sheet
Appendix II: Assessment Instruments
* Leyton Obsessional Inventory
* Yale--Brown Obsessive-Compulsive Scale
* NIMH Global Obsessive-Compulsive Scale
* Clinical Global Impairment Scale
* Clinical Global Improvement Scale
Appendix III: Resources, Tips, and Guidelines for Parents

John S. March, MD, MPH, is Director of the Program in Child and Adolescent Anxiety Disorders at Duke University Medical Center. An expert in both the cognitive-behavioral and medication management of OCD in children and adolescents, Dr. March received the 1994 Norbert and Charlotte Reiger Award from the American Academy of Child and Adolescent Psychiatry for his work on the integrated treatment of OCD. Dr. March is widely published in the areas of OCD, PTSD and pediatric psychopharmacology. His textbook, Anxiety Disorders in Children and Adolescents, is generally considered the standard work in the area. With Dr. Edna Foa, Dr. March is currently conducting a comparative study of medication, CBT and their combination in pediatric OCD funded by the National Institutes of Mental Health.

Karen Mulle, BSN, MTS, MSW, is the chief therapist in the Program in Child and Adolescent Anxiety Disorders at Duke University Medical Center.

Reviews 

"This long-awaited guide builds upon proven cognitive-behavioral techniques to provide clinical strategies and metaphors designed specifically for young OCD sufferers....Clinicians treating even one child with OCD symptoms should read this book."
-Lee Baer, PhD, Department of Psychiatry, Harvard Medical School, author of Getting Control

"This is a rare and wondrous book, clearly demonstrating that March and Mulle both know their subject and love their patients. The manual provides everything one needs to learn and do effective cognitive-behavioral therapy with children and adolescents with OCD....These strong collaborators and gifted writers have produced a work that ranks with the classics of the field."
-John H. Greist, MD, Distinguished Senior Scientist, Dean Foundation, and Clinical Professor of Psychiatry, University of Wisconsin Medical School