Class, note that my comments/corrections are in red. This
paper used a different textbook.
Â
An Analysis of Cognitive Behavioral Therapy as it Pertains to the
Treatment of Obsessive Compulsive Disorder Good title.
This paper will provide a
brief look at a popular form of treatment for Obsessive Compulsive Disorder
(OCD) known as Cognitive Behavioral Therapy (CBT). First, information from two
websites (www.nimh.nih.gov and www.ocfoundation.org )
and the Myers (2010) textbook will be discussed for general background
information about OCD. Then, CBT will be investigated from two perspectives.
Abramowitz, Foa, and Franklin’s (2003) work concerning the short-term and
long-term effectiveness of CBT will be reviewed. Then, Abramowitz, Franklin,
Schwartz, and Furr’s (2003) study concerning the effectiveness of CBT for
different symptoms will be discussed. Good. We have the purpose of
the paper, and the authors of the studies and the websites presented here. So,
we know exactly what to expect from your paper.
Myers
(2010) describes OCD as a psychological disorder whose symptoms include
obsessions and/or compulsions. According to Myers, obsessions are
uncontrollable and undesirable repetitive thoughts, while compulsions describe
obsession related actions. Common obsessions generally include thoughts related
to germs, tragedy,
and order. Typical compulsions that OCD sufferers might act out
are ritualistic hand washing, repeated locking and unlocking of doors, and
uncontrollable counting. Repetitive thoughts and actions alone are not purely
indicative of OCD. According to Myers, most individuals have daily experiences
that might resemble
OCD; however, symptoms are not considered to be caused by
OCD until they begin to actively interfere with
“everyday livingâ€. Myers notes that activities such as “cleaning before guests
arrive†or habitually lining up pencils and books before studying are normal activities. Effective use of your Myers’ text.
OCD and
the National Institute of Mental Health website
Â
Obsessive Compulsive Disorder
is a disorder that affects some 2.2 million American adults
(http://www.nimh.nih.gov). Such a widespread disorder has generated much
research and a variety of treatment options. What are the types of OCD
sufferers and does this have an impact on treatment? What currently available
CBT treatment options appear to provide the best outcome? This topic was chosen
to help answer these questions and others that might be generated during the
research process. The National Institute of Mental Health (NIMH) is a research
organization sponsored by the U.S. government specializing in mental illnesses
such as Anxiety Disorders, Bipolar Disorder, Panic Disorder and OCD.
Information presented on the NIMH website expands upon the information presented
by Myers (2010), indicating that OCD compulsions are often used as a coping
mechanism to deal with obsessions (http://www.nimh.nih.gov). Effectively, the
compulsions perform the function of anxiety reduction, which is often only
temporary. While well organized, the site does not provide much in-depth
information on the disorder. Some information pertaining directly to OCD is
present, such as a general overview and limited statistics. Missing from the
site is any useful information regarding treatment. The NIMH website therefore
seems to be of limited utility as an OCD
reference by sufferers and
non-sufferers alike. Good discussion of a National
website related to the topic.
Â
OCD and
the Obsessive Compulsive Foundation website
Â
The Obsessive Compulsive
Foundation (OCF) is an international non-profit group dedicated to providing
assistance and public education on OCD. OCF describes OCD symptoms as “a case
of mental hiccups that won’t go away†(http://www.ocfoundation.org provide paragraph number or other information so we can locate this
quote).
The good news, according to OCF, is that those seeking treatment nowadays have
better options available to them than were once available.
While it is unlikely to
completely cure OCD, according to this website, it appears that with medication
or Cognitive Behavior Therapy (CBT) most individuals end up leading normal
lives. The OCF website contains far more information and resources pertaining
directly to OCD than did the NIMH site. The site is fairly well organized and
contains relatively straight forward navigation. Good review of your second website.
Effects of
intensive versus twice-weekly sessions for OCD treatment
Â
Abramowitz, Foa, and Franklin
(2003) investigated the effects of intensive versus twice-weekly sessions for
the treatment and prevention of obsessive-compulsive
disorder. The hypothesis of the study was that the instensive treatment would produce
a more successful outcome.  Five males and 35 females
participated in the
study, aged 18 – 65. The sample was divided into two groups of 20 each. One
group received exposure, ritual prevention therapy (ERP) daily for three weeks
(IT) and the other group received ERP therapy twice a week for eight weeks
(TW). At the
beginning of the study an initial evaluation of participants in both
groups was performed, directly after which therapy was initiated. A post
treatment evaluation was performed immediately after therapy, followed three
months later by another evaluation. Upon completion of the post treatment
evaluation the results were most immediately favorable
for the IT group. However, after the three month evaluation the IT group
regressed to the level of the TW group.
According
to the study “there were no between-group differences in OCD
symptom severity or the number of patients who achieved clinically significant
improvement†after three months. Good coverage of the first
article.
There were several
limitations of this study. First, the author’s noted that there were no control
groups or nor were participants randomly assigned to groups. We don’t know if
the groups were equivalent before the treatment. There were more women in the
sample than men and the different ages of the individuals, and severity of
symptoms might have influenced the results.
Additionally, the three month
follow up period may not have allowed enough time to pass to obtain reliable
long term results. Good limitations
Severity
and type of OCD symptoms and effectiveness of cognitive-behavioral therapy
Â
Abramowitz, Franklin,
Schwartz, and Furr (2003) investigated the effectiveness of CBT when taking
into account different OCD symptoms. Participation for this study was comprised
of 70 men and 62 women between 18 and 65 years of age, all of whom had been diagnosed
with OCD.
Subjects were first assigned
to a cluster based on their existing symptoms. Cluster categories were as
follows: harming, contamination, hoarding, unacceptable thoughts, and symmetry.
Exposure-ritual prevention
therapy (ERP) was then provided over the course of 15 sessions lasting 60 to 90
minutes at a frequency of 1 to 5 sessions per week. The treatment schedule was
developed in part using information from the Abramowitz, Foa, and Franklin
(2003) study discussed above presented in conjunction with OCD symptom severity
and therapist/patient availability. Improvements were seen across all clusters;
however the hoarding cluster showed the least progress. The study noted that
“the continued development of therapies tailored especially for this particular
symptom presentation [hoarding] is importantâ€Â (Provide page number for direct quotes, but otherwise good
discussion.)
There were several
limitations of this study. Similar to the first study reviewed, this study did
not use random assignment to groups, so we do not know if the composition of
the groups was equivalent prior to the treatment. It was also not clear how the
intensity of treatment was administered, i.e., if some clusters were given more
intensive treatment than others, or if some individuals were given more
intensive treatment. This might have effected the outcome. It was also noted
that the hoarding cluster had fewer participants so the results might have been
less accurate for this group. Good limitations
Conclusion
Â
Overall, it appears that
cognitive behavioral therapy (CBT) is an effective method of treatment, though
its effectiveness can vary according to symptoms and treatment frequency.
Abramowitz, Foa, and Franklin (2003) found that intense ERP treatment provides
quick effective results; however, some symptoms tend to reappear after several
months. They found that longer, less frequent ERP treatment appears to be just
as effective in the long term as an intense regimen and has the benefit of
being more transferable to the clinical setting. Abramowitz, Franklin,
Schwartz, and Furr (2003) found that individuals exhibiting hoarding symptoms
might be less likely to respond fully to CBT, but generally still show
clinically significant improvement.
Although these studies had
limitations, both studies showed the possibilities and effectiveness of
exposure and ritual prevention (ERP) with different treatment intensities and
symptoms.
This paper also accessed the
information available online for those suffering from or interested in OCD from
the National Institute of Mental Health and the Obsessive Compulsive Foundation
websites. It was noted that the Obsessive Compulsive Foundation provided more
in-depth and more useful information as it is devoted exclusively to OCD, its
symptoms and treatment. Good. Your conclusion mentions
the studies that were reviewed and their importance and the websites.
References
Abramowitz, J. S., Foa, E. B.,
& Franklin, M. E. (2003). Exposure and ritual prevention for
Obsessive-Compulsive Disorder: Effects of intensive versus twice weekly
sessions. Journal of Consulting and
Clinical Psychology, 71, 394-398. (Needs the doi or journal
homepage.)
Abramowitz, J. S., Franklin, M. E.,
& Schwartz, S. A., & Furr, J. M. (2003). Symptom presentation and
outcome of Cognitive-Behavioral Therapy for Obsessive-Compulsive Disorder. Journal of Consulting and Clinical Psychology,
71, 1049-1057. (Needs the doi or journal homepage.)
Myers, D. G. (2010). Psychology. New York, NY: Worth Publishers
Websites:
Â
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