Dr. Piacentini and his team’s prior research identified poor family cohesion, high conflict, and high blame as significant obstacles to youths with OCD responding to exposure-based CBT. Notably, 92% of youth from families with healthy functioning across these three domains showed positive treatment outcomes, compared to only 14% of youth from families in the unhealthy range on each of these domains.
This study by Dr. Piacentini and his team aimed to develop and test a targeted parenting intervention for cases of pediatric OCD complicated by these negative family dynamics — Positive Family Interaction Therapy (PFIT). PFIT consisted of six 30-minute sessions delivered over 12 weeks as an addition to standard pediatric exposure-based CBT, and involved teaching parents and family members effective emotional regulation and family problem solving. 20 families characterized by poor functioning on measures of blame, conflict, and/or cohesion and a child with OCD took part in this study, with all children receiving exposure-based CBT for their OCD. However, half of the families received 6 hours of PFIT and the other half received a weekly supportive check-in. Youth in the PFIT condition demonstrated a 70% treatment response, while youth in the check-in condition demonstrated a response rate of only 40%, with these gains maintained at 3-month follow-up. This study showed that PFIT can significantly improve treatment outcomes for youth with OCD living in a negative family environment, and led to multiple publications.
Peris, T., Langley, A., Bergman, R.L., Benazon, N., & Piacentini, J. (2008). Parental responses to childhood obsessive compulsive disorder: The Parental Attitudes and Behaviors Scale. Child and Family Behavior Therapy, 30, 199-214. doi:10.1080/07317100802275447
Peris, T., Sugar, C., Bergman, R.L., Chang, S., Langley, A., & Piacentini, J. (2012). Family factors predict treatment outcome for pediatric obsessive compulsive disorder. Journal of Consulting and Clinical Psychology, 80, 255-263. doi:10.1037/a0027084
*Peris, T. & Piacentini, J. (2012). Optimizing treatment for complex cases of pediatric obsessive compulsive disorder: A preliminary trial. Journal of Clinical Child and Adolescent Psychology, 42, 1-8. doi:10.1080/15374416.2912.673162
Peris, T., Yadegar, M., Asarnow, J., & Piacentini, J. (2013). Pediatric obsessive compulsive disorder: Family climate as a predictor of treatment outcome. Journal of Obsessive-Compulsive and Related Disorders, 1, 267-273. doi:10.1016/j.jocrd.2012.07.003
*Peris, T. & Piacentini, J. (2014). Addressing barriers to change in the treatment of childhood obsessive compulsive disorder. Journal of Rational-Emotive & Cognitive-Behavior Therapy, 32, 31-43. doi:/10.1007/s10942-014-0183-6
Peris, T. & Piacentini, J. (2016). Positive Family Interaction Therapy for Childhood OCD. New York: Oxford University Press.
Peris, T., O’Neill, J., Rozenman, M., Bergman, R.L., Chang, S., & Piacentini, J. (2017). Developmental and clinical predictors of comorbidity for youth with obsessive compulsive disorder. Journal of Psychiatric Research, 93, 72-78. doi:10.1016/j.jpsychires.2017.05.002
Peris, T., Rozenman, M., Sugar, C., McCracken, J., & Piacentini, J. (2017). Targeted family intervention for complex cases of pediatric obsessive compulsive disorder: A randomized controlled trial. Journal of the American Academy of Child & Adolescent Psychiatry 56, 1034-1042. doi:10.1016/j.jaac.2017.10.008