Behavioral therapy in children and adolescents with obsessive-compulsive disorder: a pilot study.

Despite advances in pharmacotherapy for obsessive-compulsive disorder (OCD), medication treatments are not always effective. This pilot project examined the feasibility of a structured behavioral therapy program in the treatment of children and adolescents with OCD. Ten subjects with a primary diagnosis of OCD were invited to participate in the treatment program. Seven youngsters, 5 boys and 2 girls (age range 10.8-15.8, mean 13.0 years), participated and were treated for a mean of 14 sessions. These 7 subjects showed a broad range of OCD severity, as measured by the Children's Yale-Brown Obsessive Compulsive Scale (CYBOCS score range 12-29). Five subjects were also receiving antiobsessional medication (dose was not changed during the trial), and 2 subjects were treated without medication. All 7 youngsters showed a clinically significant reduction in the CYBOCS score at treatment endpoint (mean change 61%, range 30%-90%, effect size 2.04, p < 0.05), and the therapeutic gains were stable for at least 3 months after treatment. One of 5 children who had been receiving concurrent antiobsessional medication was able to tolerate a dose reduction following behavioral treatment. Two to three booster sessions within 6 months posttreatment were effective in preventing relapse in 4 of 6 subjects. The 3 children who declined behavioral treatment showed no improvement at 3-month and 6-month follow-up. Behavioral treatment appeared to be a useful adjunct to medication in children and adolescents with OCD. Further research could evaluate whether behavioral treatment would lower the dose requirements for children receiving antiobsessional medications. Randomized clinical trials are also needed to confirm the effectiveness of behavioral therapy alone or in combination with medication.

Gnosticism and psychology. Jung's Septem sermones ad mortuos.

In this paper, I have attempted a historical analysis of what Jung might have been thinking when he wrote the 'Seven sermons'. To this end, I tried to ascertain which Gnostic texts Jung may have consulted before writing it. These documents were then compared with the 'Seven sermons', and numerous affinities noted between it and the Gnostic texts. Jung's contemporaneous academic works were then compared with this treatise, and parallels were established between the 'Seven sermons' and Jung's emerging psychology of the unconscious. In the process, an attempt was made to show how Jung made use of Gnostic themes in his emerging psychology. While there is no way of knowing precisely what Jung was thinking when he wrote the 'Seven sermons', it is clear that he was well acquainted not only with the work of Basilides, but also with the work of other Gnostic thinkers. It is not enough to assume that because Jung chose the pseudonym of Basilides, he was necessarily Jung's primary Gnostic influence. At the same time, it is also evident that Jung was developing his own psychology during the writing of the 'Seven sermons'. We recall Jung's observations regarding the 'Seven sermons', which we quoted on page 17: These conversations with the dead formed a kind of prelude to what I had to communicate to the world about the unconscious . . . All my works, all my creative activity, has come from those initial fantasies and dreams which began in 1912, almost fifty years ago. Everything that I accomplished in later life was already contained in them, although at first only in the form of emotions and images (Jung 21, p. 192). On the basis of what has been published, there are enough affinities between his academic work and this treatise to posit that the 'Seven sermons' played an important role in the emergence of Jung's psychology. Given these numerous parallels, I suspect that Jung's unpublished writings, including the Red Book, would only strengthen the arguments put forth in this paper.