PSYCHOLOGICAL TREATMENTS FOR OCD Flashcards
What is Exposure and Response Prevention Therapy?
- A form of CBT, mainly used for OCD.
- Involves gradually exposing a person to their feared stimuli (situations, thoughts)
- Without engaging in compulsive or safety behaviours (response prevention), helping them reduce anxiety over time through habituation.
What is habituation?
- When the individual is pushed to tolerate anxiety, accept obsessions and become habituated to them.
How does Exposure and Response Prevention (EPR) therapy work?
- EXPOSURE AND PREVENTION: The individual is exposed to stimuli that provoke their obsessions and associated distress.
- HABITUATION: The individual is prevented from acting out their compulsion are instead pushed to tolerate the anxiety, accept obsessions and become habituated to it.
E.g. An individual who may fear germs may be exposed to a door handle, which would elicit obsessions surrounding dirt and germs, along with the desire to carry out a handwashing compulsion.
What is the aim of Exposure and Response Prevention therapy (ERP)?
- To prevent the performance of compulsive behaviour as a response to the distressing obsessive thought.
- Help the individual to learn that the discomfort will pass, EVEN WITHOUT performing the compulsion.
Name 1 strength and 1 weakness of using ERP as a treatment for OCD?
- Strengths (long-term benefits): ERP equips individuls with long-lasting coping mechanism, resulting in improved emotional regulation. Meaning that the improvements of the treatment can be maintainted over time (unlike drug therapies-tolerance)
- Weaknsess (difficult and emotional intense): Being exposed to the fear stimuli without responding compulsively and initial worsening of symptoms may be highly distressing leading to individuals potentially withdraw from the therapy (non-adherence)
When did Lehmkuhl et al conduct their case study on OCD?
2008
What was the aim of Lehmkul et al (2008)?
To investigate whether ERP could effectively reduce symptoms of OCD in a child patient.
What methods were used?
- (Longitudinal) Case study
- Treatment: Ten 50 min CBT sessions over 16 weeks.
Describe the sample of Lehmkuhl (2008)?
- Jason
- 12 y/o boy
- Diagnosed with OCD + High Functioning Autism
- Normal IQ score
2% of children with autism are also diagnosed with OCD-comorbidity)
Key context- Lehmkul (2008)?
Autism and OCD
- It can be difficult to distinguish ASD rituals/ behaviour from compulsive OCD behaviours.
- These rituals may give autistic people comfort but not in the same way as OCD.
- However, cleaning, checking and washing are common with OCD.
Summarise the case details of Lehmkuhl (2008)?
- Experinced contamination fear (obsessions) and (compulsions) excessive handwashing, counting and checking.
- Jason spent SEVERAL hours every day performing his compulsions and reported severe anxiety when prevented from doing so.
Can you summarise/ explain the procedure of the study?
- Identification and coping skills: Identifed feelings of distress with therapist and taught coping strategies such as reaffirming phrases ‘I know nothing will happen’.
- Exposure: Exposed to contaminated stimuli (door handles, elevator buttons). The exposures became increasingly difficult for Jason and increased his anxiety.
- Habituation: This exposure involved Jason being asked to touch these items repeatedly until he became habituated and his anxiety levels dropped.
- HOMEWORK: In between sessions Jason practiced this exposure by completing specific tasks in his normal environment (handing out papers in a classroom or using ‘contaminated’ items at home)
What was the result of Lehmkuhl (2008) study?
- After the treatment, his Y-BOCS score decreased from 18 (severe) to 3 (normal range).
- The scores remained low even in the 3 month follow up.
- He reported a sig improvement in his symptoms and partipation in school.
Name 1 strength and 1 weakness of Lehmkul et al’s case study?
- Strength (personalised treatment) The treatment can be personalised to each persons fears and responses. Ensuring the treatment is more targeted and relevant. The procedures were adjusted to accommodate Jason’s age and autism spectrum disorder (ASD).
- Weaknesses (limited generalizability): due to 1 ppts (may not generalise well to individuals with just OCD and no autism, older patients etc)
What was Jason NOT asked to do during the treatment due to his ASD?
- No visualisation exercises- as he would find it difficult to imagine pretend situations.
