Enhancing Understanding of Parental Engagement During Family-Focused Cognitive Behavioural Therapy for Early-Onset Pediatric Obsessive-Compulsive Disorder

Abstract

Introduction: Family-focused cognitive behavioural therapy (FFCBT) is emphasized as an approach to optimize treatment outcomes for early-onset obsessive-compulsive disorder (OCD). Parental engagement is critical to successful treatment. However, few studies have examined how to promote parental engagement during FFCBT. Additionally, from a parental perspective, there is a limited understanding of factors that influence parental engagement throughout treatment, including the role of nurses. Aims: To determine (i) how parents experience and understand their engagement in FFCBT provided for their child with early-onset OCD in community or outpatient mental health programs, and (ii) how parents describe the role of nurses related to parental engagement during the treatment process. Methods: This study used an interpretive description approach. Semi-structured interviews were completed with parents (n = 17) recruited from community or outpatient children’s mental health programs in the Hamilton Region of Southwestern Ontario. Treatment provider interviews (n = 9) augmented the data collected from parents’ perceptions of their engagement and the role of nurses during FFCBT. Interviews were analyzed using Braun and Clark’s (2006) thematic analysis process. Results: A conceptualized model was constructed to display and communicate the individual, interpersonal, and contextual influences identified by parents and treatment providers. These influences facilitated or inhibited parental engagement during treatment across distinct phases, levels, and stages of engagement. Six distinct nursing roles were identified that promoted parental engagement throughout treatment.