Brief Cognitive Behaviour Therapy (CBT) for Adolescent OCD in Routine Clinical Practice

NCT06983301 | Recruiting

• 2 other identifiers: 18475348693
• Study Type: interventional
• Target: 25
• Locations: 1 country
• Sites: 3

Brief Summary

Obsessive-Compulsive Disorder (OCD) is a common and often disabling condition in young people, characterised by distressing, intrusive thoughts, images or urges, and repetitive behaviours intended to reduce discomfort or prevent harm. Around 1% of adolescents in the UK experience OCD, with many cases beginning in childhood or adolescence. Cognitive Behavioural Therapy (CBT) is the recommended treatment for OCD in young people, but access to treatment is limited due to high demand, long waiting lists, and lack of trained clinicians. A brief form of CBT for OCD, supported by workbooks, has previously shown promising results in research settings. However, it remains unclear whether this approach is feasible, acceptable, and effective when delivered within routine NHS child and adolescent mental health services (CAMHS), especially for young people with co-occurring autism. This single-arm feasibility trial aims to explore whether brief CBT can be delivered effectively in routine NHS and NHS-commissioned services to young people aged 11-18 years with OCD as their main presenting problem. The trial will also assess whether the intervention is acceptable to young people, their parents/carers, and clinicians, and whether outcomes are comparable to existing evidence. Intervention Overview: The brief CBT intervention consists of five core sessions, with the option of two additional booster sessions, delivered over 24 weeks. Sessions are delivered face-to-face by trained clinicians and last between 60 to 90 minutes. The intervention is supported by a series of co-designed workbooks to be completed by the young person between sessions. Parents/carers are also provided with a workbook and encouraged to support the young person's progress where appropriate. Sessions may take place in the clinic or in other agreed settings, such as at home or school. The frequency of sessions decreases over time, with the first four sessions delivered weekly and later sessions spaced further apart. The intervention includes psychoeducation, developing a cognitive-behavioural understanding of OCD, goal setting, and techniques to support motivation and engagement. A key focus is helping young people develop cognitive flexibility by testing and challenging unhelpful beliefs that drive OCD behaviours, supported by behavioural experiments. Parents/carers and other adults in the young person's life may also be involved to help generalise learning and promote progress. Trial Aims: The trial has two primary aims: To establish whether brief CBT for OCD can be delivered with fidelity and acceptability by clinicians in NHS services, and is acceptable to young people and their families. To explore whether the intervention is associated with significant improvements in OCD symptoms for young people, including those with autism or high levels of autistic traits. Trial Design: The study is a single-arm feasibility trial. Between 20-30 young people aged 11-18 years will be recruited alongside their parents/carers. Approximately 8-10 clinicians will be trained to deliver the intervention. OCD symptoms, treatment processes, and acceptability will be assessed at baseline, post-treatment (12 weeks), and at 3-month follow-up (24 weeks). Additional measures will be collected before each therapy session. Qualitative interviews will be conducted with young people, parents/carers, and clinicians to understand their experiences of the intervention. Acceptability will also be measured using standardised questionnaires completed during and after treatment. Outcomes: The primary outcomes are feasibility and acceptability of the intervention, assessed through session attendance, participant engagement, clinician adherence, and feedback from young people, parents/carers, and clinicians. Secondary outcomes include changes in OCD symptoms, responsibility beliefs, family accommodation, and overall functioning, as well as measures of anxiety and depression. Data will be analysed to assess changes from baseline to post-treatment and follow-up, including for young people with and without autistic traits. Treatment adherence and clinician competence will also be evaluated.

Conditions

Obsessive Compulsive Disorder (OCD); CBT

Keywords

OCD; Adolescent mental health; CBT; Cognitive Behavioural Therapy; Brief psychological therapy; Obsessive Compulsive Disorder

Outcome Measures

Primary Outcomes (8)

• Credibility and Expectation of Treatment Questionnaire (CEQ; Borkovec & Nau, 1972)

  The Credibility and Expectation of Treatment Questionnaire (CEQ; Borkovec \& Nau, 1972) will be collected at baseline and used to establish treatment acceptability. Score range 0-30. Higher scores represent a better outcome.

  Baseline and follow-up (week 24)

• Experience of Service Questionnaire (ESQ; Astride-Stirling, 2002)

  The Experience of Service Questionnaire (ESQ; Astride-Stirling, 2002) will be used at the end of treatment (Week 12) and follow-up (Week 24) to measure young peoples' and parent/carers' expectations and views on the acceptability of the treatment and service.

  End of treatment (week 12) and follow-up (week 24)

• Therapist Experience of Training and Treatment Delivery Questionnaire

  The Therapist Experience of Training and Treatment Delivery Questionnaire will be given to clinicians at follow-up (Week 24) in order to establish their perceived competence, acceptability and feasibility in delivering the intervention. Score range 19-95. Higher scores represent a better outcome.

  Follow-up (week 24)

• Attrition Rate

  Feasibility will also be established by the number and rate of participants who drop-out of treatment (attrition rate).

  From enrolment to the end of follow-up (week 24)

• Therapist Adherence

  Recordings of therapy sessions will be rated by the research team to assess therapist competency and intervention adherence.

  From enrolment to the end of treatment (week 12)

• Semi-structured interviews

  Semi-structured one-to-one/joint interviews at follow-up (Week 24) exploring experiences of receiving/delivering the treatment will be conducted with participants (young people and clinicians).

  At follow-up (week 24)

• Participant Engagement with Materials

  A brief questionnaire for clinicians to rate whether the workbooks were not completed, partially completed or fully completed by the young person. To be completed following each clinical session with workbooks.

  From first intervention session (week 1) to the end of treatment (week 12)

• Session Rating Scale (SRS; Miller, Duncan & Johnson, 2002)

  The Session Rating Scale is a brief, four-item measure developed to assess the therapeutic alliance from the client's perspective in real-time. Higher scores indicate a better outcome.

  From first intervention session (week 1) to the end of follow-up (week 24)

Secondary Outcomes (10)

• Children's Yale-Brown Obsessive Compulsive Scale II (CY-BOCS-II; Abramovitch et al., 2022)

  Baseline and follow-up (week 24)

• Obsessive-Compulsive Inventory - Child Version - Revised (OCI-CV-R; Abramovitch et al., 2022)

  From baseline to follow-up (week 24)

• Child Responsibility Interpretations Questionnaire - CRIQ (Salkovskis & Williams, 2004a; Salkovskis & Williams, 2004b)

  From baseline to follow-up (week 24)

• Child Responsibility Attitude Scale - CRAS (Salkovskis & Williams, 2004a; Salkovskis & Williams, 2004b)

  From baseline to follow-up (week 24)

• Family Accommodation Scale-Parent Report (FAS-PR) (Peris et al., 2008; Storch et al., 2007)

  Baseline, end of treatment (week 12) and at follow-up (week 24).

Study Arms (1)

Treatment

EXPERIMENTAL

Brief CBT for OCD intervention delivered

Other: Brief Cognitive Behavioural Therapy (CBT) for OCD

Interventions

Brief Cognitive Behavioural Therapy (CBT) for OCD OTHER

A brief 5-session CBT face-to-face intervention (therapist supported, involving workbooks) for adolescent Obsessive Compulsive Disorder (OCD). The brief CBT consists of 5 sessions of 60 to 90-minutes, with the option of 2 additional booster sessions (also 60 to 90 minutes), spanning a total of 24 weeks. The intervention includes home tasks, completion of regular routine outcome measures and participants listening to audio-recordings of the therapy sessions. The intervention sessions are delivered by routine child and adolescent mental health services (CAMHS) practitioners and take place in NHS and NHS-commissioned child and adolescent mental health services.

Treatment

Eligibility Criteria

• Age: 11 Years - 18 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Child (0-17), Adult (18-64)

You may qualify if:

• Young people:
• Willing and able to give informed assent (if aged 11-15 years, and parent/carer consent is provided) or consent (if aged 16-18 years) for participation in the study.
• Aged 11 to 18 years at the time of recruitment.
• Diagnosed with OCD using the Anxiety Disorders Interview Schedule (ADIS) and OCD has been identified as the primary problem.
• If on pharmacotherapy for OCD, then stable dose for at least 6 weeks prior to trial entry.
• Able to speak and read English at a sufficient level to be able to read and understand the workbooks and materials and complete exercises in the workbooks.
• Willing to engage in the treatment.
• In the Investigator's opinion, is able and willing to comply with all trial requirements.
• Willing to allow his or her General Practitioner and consultant, if appropriate, to be notified of participation in the trial.
• Parents/carers:
• Able and willing to provide written informed consent for their child's participation in the study.
• Able to read the parent/carer workbook and materials.
• Willing and able to participate.
• Clinicians:
• Working within a participating NHS or NHS-commissioned service.

You may not qualify if:

• Young people:
• The clinical assessment indicates that risk/safeguarding cannot be safely managed within the service.
• Any other significant disease or disorder which, in the opinion of the Investigator, may either put the participants at risk because of participation in the trial, or may influence the result of the trial, or the participant's ability to participate in the trial.
• Evidence of learning difficulties identified by schools or evident at interview that would inhibit participation in cognitive components of therapy.
• Currently receiving a psychological intervention for OCD.
• Parents/carers:
• Clinicians:

Sponsors & Collaborators

• University of Oxford: lead

Study Sites (3)

AnDY Research Clinic

Reading, Berkshire, RG6 6AL, United Kingdom

RECRUITING

Department of Experimental Psychology

Oxford, Oxfordshire, OX2 6GG, United Kingdom

NOT YET RECRUITING

AnDY Research Clinic Oxford

Oxford, Oxfordshire, OX4 3LX, United Kingdom

NOT YET RECRUITING

Related Publications (2)

• Dell'Osso B, Benatti B, Hollander E, Fineberg N, Stein DJ, Lochner C, Nicolini H, Lanzagorta N, Palazzo C, Altamura AC, Marazziti D, Pallanti S, Van Ameringen M, Karamustafalioglu O, Drummond LM, Hranov L, Figee M, Grant JE, Zohar J, Denys D, Menchon JM. Childhood, adolescent and adult age at onset and related clinical correlates in obsessive-compulsive disorder: a report from the International College of Obsessive-Compulsive Spectrum Disorders (ICOCS). Int J Psychiatry Clin Pract. 2016 Nov;20(4):210-7. doi: 10.1080/13651501.2016.1207087. Epub 2016 Jul 19.

  PMID: 27433835 BACKGROUND

• Bolton D, Williams T, Perrin S, Atkinson L, Gallop C, Waite P, Salkovskis P. Randomized controlled trial of full and brief cognitive-behaviour therapy and wait-list for paediatric obsessive-compulsive disorder. J Child Psychol Psychiatry. 2011 Dec;52(12):1269-78. doi: 10.1111/j.1469-7610.2011.02419.x. Epub 2011 Jun 3.

  PMID: 21644984 BACKGROUND

MeSH Terms

Conditions

Obsessive-Compulsive Disorder

Condition Hierarchy (Ancestors)

Anxiety Disorders; Mental Disorders

Central Study Contacts

Polly Waite

CONTACT

+441865 271430; polly.waite@psy.ox.ac.uk

Lucas Shelemy

CONTACT

lucas.shelemy@psy.ox.ac.uk

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: NA
• Masking: NONE
• Purpose: TREATMENT
• Intervention Model: SINGLE GROUP
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Model Details: This study is a multicentre single-arm (no blinding) feasibility intervention trial implementing brief CBT (supplemented with workbooks) to treat adolescents who meet diagnostic criteria for OCD.

Study Record Dates

• First Submitted: April 1, 2025
• First Posted: May 21, 2025
• Study Start: May 2, 2025
• Primary Completion: March 31, 2026
• Study Completion: March 31, 2026
• Last Updated: May 21, 2025

Record last verified: 2025-03

Data Sharing

• IPD Sharing: Will share

Locations

GB (3)