Cognitive-Behavioral Therapy for Pediatric Obsessive-Compulsive Disorder Complicated by Stigma: A Case Study

Nearly 50% of children continue to experience obsessive-compulsive disorder (OCD) symptoms and impairment at the end of traditional Cognitive-Behavioral Therapy (CBT), and some studies suggest that stigma may complicate the course of CBT for OCD. This case study describes the use of CBT for a 9-year-old boy, "Isaac," who was diagnosed with OCD and was experiencing stigma related to a visible physical handicap. Manualized CBT was conducted, and substantial improvement in OCD symptoms and functioning emerged. However, given the persistence of obsessions, which we believed to be particularly difficult to resist given the visibility of his handicap and associated stigma, additional booster sessions were included, from which more improvements emerged, and they were maintained over a year. Thus, this case study illustrates the benefit of addressing OCD symptoms and impairment as well as other complicating factors, such as stigma, in the course of treatment.