Parent Management Training Augmentation to Address Coercive and Disruptive Behavior in Cognitive-Behavioral Therapy for Pediatric Obsessive-Compulsive Disorder

David A Schuberth; Robert J McMahon; John R Best; Katherine McKenney; Robert Selles; S Evelyn Stewart

doi:10.1007/s10578-023-01543-8

Parent Management Training Augmentation to Address Coercive and Disruptive Behavior in Cognitive-Behavioral Therapy for Pediatric Obsessive-Compulsive Disorder

Child Psychiatry Hum Dev. 2023 May 20. doi: 10.1007/s10578-023-01543-8. Online ahead of print.

Authors

David A Schuberth^{1

2}, Robert J McMahon^{3

4}, John R Best⁴, Katherine McKenney⁵, Robert Selles⁵, S Evelyn Stewart^{4

5}

Affiliations

¹ Department of Psychology, Simon Fraser University, Burnaby, BC, V5A 1S6, Canada. dschuber@sfu.ca.
² BC Children's Hospital Research Institute, Vancouver, BC, Canada. dschuber@sfu.ca.
³ Department of Psychology, Simon Fraser University, Burnaby, BC, V5A 1S6, Canada.
⁴ BC Children's Hospital Research Institute, Vancouver, BC, Canada.
⁵ Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada.

PMID: 37209194
DOI: 10.1007/s10578-023-01543-8

Abstract

Coercive and disruptive behaviors commonly interfere with cognitive-behavioral therapy (CBT) trials among youths with obsessive-compulsive disorder (OCD). Although evidence supports parent management training (PMT) for reducing disruptive behavior, no group-based PMT interventions exist for OCD-related disruptive behaviors. We studied feasibility and effectiveness of group-based adjunctive PMT among non-randomized, OCD-affected families receiving family-based group CBT. Linear mixed models estimated treatment effects across OCD-related and parenting outcomes at post-treatment and 1-month follow-up. Treatment response for 37 families receiving CBT + PMT (M_age= 13.90) was compared to 80 families receiving only CBT (M_age= 13.93). CBT + PMT was highly accepted by families. Families who received CBT + PMT had improved disruptive behaviors, parental distress tolerance, and other OCD-related outcomes. OCD-related outcomes did not significantly differ between groups. Results support CBT + PMT as effective treatment for pediatric OCD that may not provide incremental benefits beyond CBT alone. Future research should determine feasible and effective ways to incorporate key PMT components into CBT-based interventions.

Keywords: Child/adolescent; Cognitive-behavioral therapy; Disruptive behavior problems; Obsessive-compulsive disorder; Parent management training.