Social Psychiatry, Vol. 53 No. 4, 2025.
Case report, case study
https://doi.org/10.24869/spsih.2025.374
Inference-Based Cognitive-Behavioral Therapy for Obsessive-Compulsive Disorder in Children and Adolescents
Vlatka Boričević Maršanić
; Center for Children, Adolescents and Parents, Zagreb, Croatia
Emilija Maršanić
; School of Medicine, University of Zagreb, Zagreb, Croatia
Abstract
Inference-Based Cognitive-Behavioral Therapy (I-CBT) offers a distinct approach to obsessive–compulsive disorder
(OCD) that is conceptually different than the traditional CBT model, emphasizing inferential confusion – the tendency to
treat imagined possibilities as equivalent to reality – and how compulsions reinforce this misperception. By highlighting
the difference between imagination and reality, I-CBT targets the cognitive processes that maintain obsessive thinking.
Although studies on adults have shown promising outcomes, its application in children and adolescents remains limited.
This article reviews the theoretical foundations of I-CBT, considers the key developmental factors, and illustrates its clinical
application through a case report of a 13-year-old girl with danger-related intrusive thoughts and compulsive rituals.
Developmental aspects such as heightened imaginative capacity, evolving metacognition, and family accommodation
in cases of pediatric OCD are examined as contributors to symptom maintenance and potential therapeutic leverage
points. By integrating the evidence obtained from adult-based I-CBT studies with established pediatric OCD interventions,
the discussion identifies the opportunities for innovation and adaptation. Despite the lack of controlled pediatric trials,
preliminary clinical observations suggest that I-CBT may serve as a developmentally sensitive alternative or complement
to exposure-based CBT for children. Future studies should evaluate the feasibility, mechanisms of change, and the role of
parental involvement. Overall, I-CBT represents a promising emerging intervention capable of expanding the treatment
options for children and adolescents with OCD.
Keywords
OCD; Children; CBT; I-CBT; Inferential Confusion
Hrčak ID:
345538
URI
Publication date:
26.12.2025.
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