Research has supported the effectiveness of ERP in treating patients with OCD. For example, an investigation by Albucher et al (1998) showed that between 60 and 90% of patients who suffered with OCD improved considerably using ERP. Furthermore Foa and Kozak (1996) support Albucher’s claims, as their research demonstrated that ERP alone was as effective as ERP with medication after a two year follow up. Empirical evidence such as this enables the ERP therapy to be generalized as a universally effective treatment for OCD patients.
A criticism in the use of psychological therapies for treating OCD is that its reductionist. For instance the behavioral approach assumes that obsessions and compulsions are learnt through conditioning and are maintained by negative reinforcement, however does not consider underlying biological factors such as abnormalities in the frontal lobes of the brains of patients suffering from OCD. Research from Foa et al (2005) demonstrated that a combination of the tricyclic clomipramine and ERP (exposure and response prevention) was more effective in treating symptoms of OCD than using either alone. This suggests that psychological treatments over-simplify OCD in terms of assuming that OCD is a result of learning and maintaining obsessions and compulsion through reinforcement but research has acknowledged that there may also be other elements affecting OCD and therefore requires a combination of therapies to prove effective in treating OCD.
Another psychological therapy is cognitive therapy (CT). This involves the psychiatrist questioning the patient on how they interpret their obsessions (their attitude to the obsession and the reason they believe they have the obsession). This anxiety evoking obsession is then challenged and misinterpreted so that that obsession is not perceived as a high risk activity. For example an individual who may believe that shaking hands with another person will contaminate them of ‘germs’ will be explained that such contamination is unlikely with certain evidence and information. Secondly the patient is questioned about the value of their compulsive behaviors, which is then challenged and explained as false which enables patients to control such compulsive behaviors (washing hands for 5 minutes opposed to 30 minutes).
Researchers such as Wilhelm et al (2005) investigated the effectiveness of CT and found significant improvement in 15 patients who used CT alone for 14 sessions. Although this demonstrates the effectiveness of CT, in the study limited numbers of patients were examined. This makes it difficult to generalize that CT maybe effective to all extremities and variations of OCD as in real life CT is very rarely given on its own but accompanied by other treatments such as chemotherapy, suggesting that CT is probably not the best treatment for OCD as combination of treatments must be taken alongside CT in order for it to be an effective solution.
An issue surrounding the treatment of CT is that it may not be appropriate for all patients. For instance, CT requires considerable effort and motivation from the patient to prove effective. The therapy on average takes around 14-20 weekly sessions (may be more or less depending on the extremity of the obsessions and compulsions) which requires commitment and persistence in order to see results. For example the patient has to practice maintaining their new ‘interpretations’ on anxiety evoking situations in order to prove effectiveness. This may be perceived as a huge effort for a patient who may view drug therapies (chemotherapy) as easy consequently motivating them to discontinue with the course (due to its lengthy nature whose results are witnessed only in the long term) thus proving the inefficiency of CT.
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jeb1232 (student)
