The onset of obsessive-compulsive disorder often occurs in childhood and adolescence. Paediatric OCD can be an extremely debilitating disorder, resulting in high levels of distress, impairment and disruption of psychosocial development. It also has a considerable impact on other family members. While there is evidence that medication can reduce symptoms, behavioural and cognitive-behavioural therapy (BT/CBT) are often proposed as acceptable alternative treatments. These therapies include assisting the child to better tolerate the anxiety-provoking situations and thoughts without the use of compulsive behaviour to manage their anxiety, psycho-educationabout anxiety and OCD; cognitive therapy in which the child is helped to learn to identify and challenge unhelpful ways of thinking; and parental support.
This review identified eight randomised controlled trials involving 343 participants, evaluating the benefits of behavioural and cognitive-behavioural therapy. The results show that, compared to a wait-list or pill placebo, BT/CBT is an effective treatment for reducing OCD symptoms and lowering the risk of having OCD after treatment. Based on three studies that directly compared BT/CBT with medication, there was no current evidence to suggest that either BT/CBT or medication was superior to the other. When combined with medication, BT/CBT produces better outcomes than medication alone. Although based on a small number of studies, these findings provide support for the value of BT/CBT in the treatment of children and adolescents with OCD.