Symposia
Telehealth/m-Health
Martin E. Franklin, Ph.D.
Rogers Behavioral Health
Philadelphia, Pennsylvania
Pediatric OCD Talk Abstract (1,803 characters)
Obsessive compulsive disorder (OCD) is associated with substantial impairment in affected youth. Fortunately, cognitive-behavioral therapy (CBT) involving exposure plus response prevention (ERP) has emerged consistently as effacious. Application of ERP telehealth (TH) protocols have also proven effective, yet little is known specifically about TH outcomes for youth receiving treatment at higher levels of care such in Intensive Outpatient (IOP) or Partial Hospitalization (PHP) programs. The COVID-19 global pandemic in 2020 forced many programs to pivot immediately to TH, which necessitated our study of its effectiveness in this context. Towards this end, we examined changes in OCD symptoms and quality of life in 643 youth (55% female) ages 7 - 17 treated at higher levels of care during the COVID-19 global pandemic, and matched our sample to a group of 643 youth (66% female) treated in person (IP). Planned pairwise comparisons indicated that TH patients discharged with a statistically higher mean CY-BOCS score (16.6) than those who received IP (15.2), although this mean between group difference (1.4) failed to meet the standard for clinical significance. In terms of predictors, older patients discharged with a higher mean CY-BOCS than younger patients, and patients who stayed longer in treatment had a lower mean CY-BOCS at discharge. Finally, individuals with more diagnoses discharged with a higher mean CY-BOCS scores than individuals with fewer diagnoses. Quality of life findings generally mirrored those found with the OCD symptom measure. Youth receiving multi-modal TH treatment at a higher level of care responded both well and comparably to those treated IP, which thus offers a viable path forward for families who cannot readily access IP OCD services. Secondary analyses will examine: a) effects of medication status on treatment outcome; b) treatment response by modality in ethnic and racial minorities; and c) the use of advanced statistical methodologies to identify patient subgroups more or less likely to respond to treatment in general or to either treatment specifically.