Introduction to the Two‐Part Special Issue (Issues 2 and 3): Innovations in the Treatment of Obsessive‐Compulsive and Spectrum Disorders

Abstract

Obsessive-compulsive disorder (OCD) and obsessive-compulsive (OC) spectrum disorders are among the most prevalent psychiatric conditions. They are often chronic, and they impair functioning. Cognitive-behavioral therapy (CBT)—with or without medication—is the treatment of choice, yet many questions about assessment protocols and the delivery of treatment remain. For instance, what are the most effective assessment tools and methods for measuring the types and intensity OCD spectrum disorders and their various forms? How do cognitive and behavioral methods differ? Is cognitive therapy alone effective? With comorbid OCD, substance abuse, and depression, which disorder should be treated first? Do some patients benefit more from a group modality? Should family members be included in treatment? How does CBT for kids differ from the treatment for adults? How is CBT for the OC spectrum disorders implemented? What is the role of medication in CBT? This special two-part issue of Brief Treatment and Crisis Intervention is devoted to innovative evidence-based treatments of OCD and OC spectrum disorders. Experts in the field have contributed articles covering a broad range of topics targeted specifically for clinical practitioners. Most articles include clinical case examples to illustrate therapy methods and some of the complexities of applying these treatments. It is an exciting time to be providing treatment to people with OCD and OC spectrum disorders because of the wealth of clinical research that has resulted in the development of efficacious treatments that are replicable. To open this special issue, the paper by Maltby and Tolin provides an overview of treatments for OCD and spectrum conditions. These clinical researchers outline current concerns about the concept of OC spectrum conditions and models for treatment. They review literature regarding the accepted behavioral treatment of choice, exposure, and response prevention, and they note some common obstacles that face clinicians in delivering this therapy. A stepped care model is presented as an important concept in addressing OCD symptoms. Next, Steketee and Neziroglu summarize a variety of assessment tools for use with OCD and OC spectrum conditions that are particularly useful in helping clinicians determine what problems to address in treatment and whether therapy is having the desired effect. Included are clinician interviews, self-report questionnaires, clinician-rated forms, and behavioral observations and self-monitoring by the patient. Roberts, Seigel, and Yeager examine the nature and prevalence estimates, symptom clusters, treatment plans, and research on comorbid OCD with substance abuse, and/or major depression and suicide ideation. Case examples