Just say no: Sequential parent management training and cognitive-behavioral therapy for a child with comorbid disruptive behavior and obsessive compulsive disorder

Psychiatric comorbidity is common in pediatric patients with obsessive-compulsive disorder (OCD) and may negatively affect treatment outcome. In particular, comorbid disruptive behavior disorders have been associated with attenuated treatment response in youth undergoing cognitive-behavioral therapy (CBT) for OCD. This article presents the case of a 10-year-old female with a primary diagnosis of OCD and secondary diagnosis of oppositional defiant disorder who was successfully treated with parent management training (PMT) prior to initiation of CBT. PMT was effective in reducing oppositional behaviors and resulted in improved adherence to the treatment protocol. The current report provides preliminary evidence for the effectiveness of PMT in youth with OCD and comorbid disruptive behavior. Clinical recommendations are provided to foster improved outcomes in this population.