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McLean Hospital, the largest psychiatric affiliate of Harvard Medical School, has added a new program to its McLean SouthEast campus in Middleborough. The McLean Child Adolescent OCD Institute, which opened last month, is the second of its kind in the country to use exposure and response prevention (ERP) and acceptance and commitment therapy (ACT) for treating children and teens ages 10 to 17 struggling with OCD and anxiety.
“What’s unique about us is that we use evidence-based behavioral treatments, along with augmentative approaches, that help children and teens learn to develop a different relationship with their difficult thoughts and emotions so that they are able to live lives that matter to them,” said Lisa W. Coyne, PhD, the program’s director and faculty member in the department of Child and Adolescent Psychiatry at Harvard Medical School. “There are no other programs in the country that are residential that do this.”
The program, which can support 12 residents and is associated with the McLean OCD Institute, is comprised of a multidisciplinary treatment team that includes behavior therapists/psychologists, psychiatrists, family therapists, milieu therapists, and educational staff who have expertise in assessing and treating complex OCD and related conditions.
“The treatment that we use is the gold standard intervention for these disorders,” said Coyne. “We have a lengthy wait list and get calls every day from families looking for services for their children with severe OCD or anxiety. These kids who come to us have either not done well in outpatient treatment, have not had the right level of care or treatment, or are so severe that sometimes they are put into acute inpatient programs that do not use exposure and response prevention, and the treatment is just not appropriate. They have a really bad experience where they go for stabilization but they don’t get much out of it because it’s just not what they need.”
“That’s why we have this specialty program where we know how to work with kids with OCD and anxiety,” she said. “What’s really exciting and rewarding is that it’s an active and intensive treatment program. If the kids engage in it, and if the families are supportive, they will get better. I can’t tell you how amazing it is to watch.”
The program schedule, said Coyne, integrates heavy exposure throughout the day, run by psychologists who head multidisciplinary teams, including social workers, psychiatrists, and community residence counselors (CRCs) who serve as exposure coaches.
So far the program has its first few teens, ages 14 to 17 and it is filling up quickly. “Families are calling from all over the United States and as far away as Hong Kong, Canada, and Australia,” she said.
“It’s important to me that this clinic is open to everyone—not just those who can afford it, so we are doing a ton of work on outreach, disseminating information, writing grants, and looking at internet-delivered intervention for families who can’t get to us. We also want to do training where we can invite local providers and show them that this is an evidence-based treatment that works really well,” said Coyne.
Looking ahead, she said some of the goals for the program include helping to improve access to care and facilitate early childhood intervention. “The average length of time that people wait for appropriate treatment for OCD is seven years,” she said. “These kids need services and we need to get them effective treatment earlier.”
“We also have a strong infrastructure in place for data collection around program evaluation and we’re also doing clinical research on severe OCD and our treatment approach.”
“Five to 10 years from now,” said Coyne, “I want to get some calls from these kids who are thriving, telling me that life is good and that they’re happy, and that they are in relationships with people who love them... that they are free agents of their experience, and that they can take care of themselves and live lives that matters to them. And I hope that they turn around and help other kids take those first, scary steps.”