Intensive Psychotherapy Treatment Options for Pediatric Obsessive-Compulsive Disorder.

Obsessive-compulsive disorder (OCD), affecting ∼1% of the population,1 is characterized by intrusive thoughts and compulsive behaviors that cause significant distress and impairment. Following an evidence-based assessment to identify OCD and to differentiate co-occurring conditions,2 the front-line treatment is outpatient cognitive behavioral therapy (CBT) with exposure and response prevention (ERP), with or without serotonin reuptake inhibitors (SRIs).3 In severe cases, augmentation with neuroleptics is often used. Although standard outpatient treatment reduces OCD symptoms,4 many youth do not fully respond3 and require more intensive care, such as intensively delivered ERP. This article aims to guide clinicians in referring patients with severe and/or treatment-refractory OCD-defined as a failure of 2 SRI trials of adequate dose and duration and an adequate ERP trial-to appropriate intensive psychotherapeutic treatment.