Pediatric obsessive-compulsive disorder (OCD) is a severely impairing disorder, characterized by recurrent obsessions and compulsions causing significant impairments in daily activities and family functioning. Approximately 40% of youth with OCD do not benefit from first-line treatment options (cognitive behavioral therapy; CBT, or medication). Increasing attention is given to family factors related to childhood OCD, in particular family accommodation (FA). FA encompasses behaviors of parents, siblings, and other caregivers to alleviate distress in the affected child. FA is highly prevalent in families of children with anxiety disorders and OCD and predict greater symptom severity and poorer treatment outcomes.
Supportive Parenting for Anxious Childhood Emotions (SPACE) is a parent-based treatment, that focuses on FA, thereby aiming to improve the child’s OCD. SPACE is a manualized protocol, containing 12 treatment sessions, in which parents are taught to reduce FA and to increase supportive responses to their child.
The objective of this study is to investigate whether SPACE is effective in reducing FA and OCD symptoms in children with complex OCD, that did not benefit from first-line treatment options. A multiple baseline, single-case experimental design (SCED) will be applied. The course of the study consists of a baseline phase, treatment phase and follow-up phase. In total 25 youth (7-18 years) with OCD, who previously received cognitive behavioral therapy (CBT) unsuccessfully, aborted treatment early, or were not able to receive CBT due to too high levels of OCD/anxiety, and their parents will be included. They will be randomly allocated to one of three baseline phase options (4, 6 or 8 weeks). The treatment phase consists of 12 weekly sessions of SPACE with parents. Throughout all phases, OCD severity and FA will be briefly assessed thrice a week. Standard clinical measurements assessing OCD severity and FA and secondary parameters will be conducted at six timepoints, till 6 months follow-up.

This study is funded by Fonds SGS, een innovatiefonds van Zilveren Kruis.