Dr Lara Farrell
Griffith University, QLD
Mental Health Research 2009
Dr Lara Farrell is a clinical psychologist who specialises in the assessment, treatment and prevention of anxiety disorders and obsessive-compulsive disorder (OCD) in children and youth.
Dr Farrell graduated from Griffith University in 2001 with a Clinical Masters degree and received her PhD in 2004. Dr Farrell currently holds a Post-Doctoral Research Fellowship at the Griffith University, where she continues her clinical research in the field of assessment and treatment of emotional disorders in children and youth.
Dr Farrell has contributed considerably to the field of research in the area of child anxiety and OCD interventions. She has published in internationally renowned psychology and psychiatry journals and has published numerous book chapters in dedicated edited texts on these topics.
Dr Farrell regularly presents scientific research and training workshops. She also talks to community groups at local schools and support groups. Dr Farrell has a small private practice at Lakeside Rooms Robina, on the Gold Coast.
SUMMARY OF PROJECT:
A Novel Approach to Treatment Resistant Childhood Obsessive-Compulsive Disorder: D-Cycloserine Augmented Behaviour Therapy
Sixty percent of children with obsessive-compulsive disorder do not get better, even after best practice psychological treatment. Dr Lara Farrell’s study will provide data on the first randomised control trial for treatment resistant childhood obsessive-compulsive disorder.
Treatment evaluated in this project involves combining the “active ingredient” of existing psychological therapy – Exposure and Response Prevention – with D-Cycloserine, a drug traditionally used to treat tuberculosis. D-Cycloserine can assist in reducing fears and improving treatment outcomes when combined with Exposure and Response Prevention in social phobia, fear of heights, and adult obsessive-compulsive disorder.
D-Cycloserine improves Exposure and Response Prevention by enhancing learning during therapy; effectively speeding up process and outcomes of Exposure and Response Prevention. The drug offers exciting and promising improvement in the treatment of severe anxiety disorders including obsessive-compulsive disorder in adults.
Dr Farrell’s study will compare the effectiveness of Exposure and Response Prevention combined with D-Cycloserine with a control condition of Exposure and Response Prevention combined with a placebo pill. It is expected that children in Exposure and Response Prevention + D-Cycloserine will demonstrate significantly greater symptom reductions and maintain improvements longer term.
This research should:
• improve outcomes for children suffering severe and chronic obsessive-compulsive disorder
• prevent lifelong suffering and economic burden to families and the wider community
• provide an innovative, cost and time efficient approach to treating those in greatest need
thus benefiting thousands of Australians and children worldwide who have an obsessive-compulsive disorder.
FINAL REPORT
Obsessive Compulsive Disorder (OCD) is a debilitating neurobehavioural disorder in which a person’s obsession with germs, illness or injury results in extreme behaviours, such as excessive washing of the hands, repeatedly walking through doorways or obsessive attention to detail when dealing with random objects.
3% of children and youth live with an OCD and while 50% of these cases are considered diagnosis free following treatments such as cognitive behavioural treatment the remaining 50% do not respond to treatments.
Dr. Farrells study involved the treatment of 17 children and youth (8-17 years) with obsessive compulsive disorder who had been unresponsive to any other treatments using D-Cycloserine, a drug proposed to enhance learning and ultimately improve exposure and response prevention.
Participants were split into two groups, one of which received augmented cognitive behavioural treatment made up of exposure and response prevention with D-Cycloserine and the other receiving cognitive behavioral therapy involving exposure and response prevention and a placebo pill.
Both treatment groups showed significant improvements across all outcome measures with 78% of participants responding to treatment in the D-Cycloserine group compared to 62% in the placebo group. These findings indicate that D-Cycloserine made more significant improvements to the obsessive compulsive disorder severity compared to the placebo.
The findings were a world first in developing a novel approach to improve outcomes for obssesive compulsive disorder patients who were previously unresponsive to treatment. The study also represents the first step in finding more approaches to the treatment of obsessive compulsive disorders in other age groups including adults.
The study has also paved the way for more extensive research projects to be undertaken in the future using a larger sample which will further determine the worth of the new treatment to patients and provide clinical guidelines to practitioners for the different levels of treatment based on the severity of the disorder.