Cognitive-behavioral intervention in the management of obsessions and compulsions of washing in a girl with obsessive-compulsive disorder

Behavioral-cognitive therapy for cleaning obsessions and compulsions in a girl with obsessive-compulsive disorder. A single-case study of a 10-years old girl diagnosed with obsessive-compulsive disorder (OCD) is presented. Cognitive-behavioral techniques were used for cleaning obsessions and compulsions. We carried out continuous assessment by means of observational records filled out by the parents and their child. Furthermore we conducted a pre-test-posttest assessment based on the Children's Yale-Brown Obsessive Compulsive Scale (CY-BOCS). We used behavioral as well as cognitive techniques, illustrated with pictures and pictograms in order to ease the child understanding and her learning. Exposure and response prevention (ERP) was the main technique used in the treatment, complemented by cognitive techniques (cognitive restructuring and self-instructional training) and a reinforcement program. The results were successful, with a great decrease in the cleaning obsessions and compulsions. This study highlights the importance of a treatment model with emphasis on cognitive training and parental involvement in addition to the EPR technique as vertebral aspect of intervention for children with OCD onset in childhood.