Class, note that my comments/corrections are in red. This paper used a different textbook.
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 living”. 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
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.
OCD and the Obsessive Compulsive Foundation website
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
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
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 important” (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
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.
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:
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