CBT specific process in exposure-based treatments: Initial examination in a pediatric OCD sample

Cognitive-behavioral theory and empirical support suggest that optimal activation of fear is a critical component for successful exposure treatment. Using this theory, we developed coding methodology for measuring CBT-specific process during exposure. We piloted this methodology in a sample of young children (N=18) who previously received CBT as part of a randomized controlled trial. Results supported the preliminary reliability and predictive validity of coding variables with 12 weeks and 3 months treatment outcome data, generally showing results consistent with CBT theory. However, given our limited and restricted sample, additional testing is warranted. Measurement of CBT-specific process using this methodology may have implications for understanding mechanism of change in exposure-based treatments and for improving dissemination efforts through identification of therapist behaviors associated with improved outcome.

► We study CBT-specific process based on theoretical need for fear activation. ► We test this methodology in a sample of young children (N=18). ► Results support initial reliability and predictive validity. ► Future efforts should test CBT-specific process in an expanded sample. ► Use of this methodology will benefit mechanism and dissemination research.