4 - (IOP 16) Training the Next Generation of Pediatric OCD Exposure Therapists: Outcomes of the IOCDF Pediatric BTTI

Cognitive Behavioral Therapy (CBT) is the most efficacious psychological treatment for pediatric OCD; however, many providers do not feel competent to conduct exposure therapy with these patients. The IOCDF Behavior Therapy Training Institute (BTTI) aims to broaden the workforce of clinicians trained in CBT for OCD. Preliminary outcomes of the adult BTTI are promising (Jacoby et al., 2019); however, outcomes from the pediatric BTTI have not been tested, which is important given unique considerations for treating children with OCD. Accordingly, the present study prospectively examined outcomes of the pediatric BTTI and tested possible demographic predictors of change. Clinicians (N=159) who completed the child OCD BTTI from 1/2016-11/2019 (86% female, 86% Caucasian, M(SD) age = 41.6(10.0), 43% doctorate) completed measures before (PRE; n=159), immediately after (POST; n=156), and 6-months following the workshops (6MFU; n=81). Using multi-level modeling, we found significant effects of time for the following outcomes: (a) increased self-reported comfort assessing and treating OCD from PRE (estimated marginal mean (EMM): 69.0 out of 100) to POST (EMM=87.5; p<.001; ES=0.98) that deceased slightly at 6MFU (EMM=85.4; p=.04; ES=-0.11) but remained higher than pre-workshop levels (p= <.001; ES=0.87); (b) increased knowledge scores from PRE (EMM=72.0 out of 100%) to POST (EMM=90.2; p<.001; ES=0.53) in a sub-sample of n=62 participants who had less than perfect knowledge scores pre-training; (c) increased positive beliefs about exposure therapy from PRE (EMM=87.0 out of 100) to POST (EMM=89.7; p=.0002; ES=0.28); however, these effect sizes were small and were no longer significant at 6MFU (EMM=86.8; p=.83; ES=-0.02); and (d) increased percentage of children with OCD on clinicians’ caseloads from PRE to 6MFU (EMM change score=9.8%; p=.02; ES=0.39) among a sub-sample of n=75 clinicians reporting their caseloads at follow-up. Results indicate that the pediatric BTTI increased clinician knowledge and comfort assessing and treating pediatric OCD from pre- to post-workshop with gains maintained 6-months later, and that clinicians were seeing a higher percentage of pediatric patients with OCD in their practices. None of our demographic predictors (age, gender, race, ethnicity, years of experience) significantly predicted outcomes after adjusting for BTTI group effects and pre-training levels, suggesting the training was effective across demographic backgrounds. Future research should test outcomes in a more diverse group of clinicians.