Participant perspectives on the acceptability and effectiveness of mindfulness-based cognitive behaviour therapy approaches for obsessive compulsive disorder.

Tamara Leeuwerik,Claire Rosten,Clara Strauss,Laura Lea,Elizabeth Forrester,Anna-Marie Jones,Claire Hoadley,Kate Cavanagh

doi:10.1371/journal.pone.0238845

Abstract

Cognitive behavioural therapy (CBT) which includes Exposure and Response (ERP) is a highly effective, gold standard treatment for Obsessive-Compulsive Disorder (OCD). Nonetheless, not all patients with OCD significantly benefit from CBT. This has generated interest in the potential benefits of Mindfulness-Based Interventions (MBIs), either integrated with CBT, to enhance engagement with ERP tasks, or delivered as a stand-alone, first-line or therapy to augment CBT. This paper reports on two qualitative studies that involved a thematic analysis of interview data with participants in a 10-week Mindfulness-Based ERP (MB-ERP) course (study 1) and a 9-week Mindfulness-Based Cognitive Therapy course adapted for OCD (MBCT-OCD) (study 2). Whilst MB-ERP integrated a mindfulness component into a standard ERP protocol, MBCT-OCD adapted the psychoeducational components of the standard MBCT for depression protocol to suit OCD, but without explicit ERP tasks. Three common main themes emerged across MB-ERP and MBCT-OCD: ‘satisfaction with course features’, ‘acceptability of key therapeutic tasks ‘and ‘using mindfulness to respond differently to OCD’. Sub-themes identified under the first two main themes were mostly unique to MB-ERP or MBCT-OCD, with the exception of ‘(struggles with) developing a mindfulness practice routine’ whilst most of the sub-themes under the last main theme were shared across MB-ERP and MBCT-OCD participants. Findings suggested that participants generally perceived both MBIs as acceptable and potentially beneficial treatments for OCD, in line with theorised mechanisms of change.

Highlights

Obsessive-compulsive disorder (OCD) is a debilitating mental health condition characterised by persistent intrusive thoughts, images or urges that cause significant anxiety or discomfort, and repetitive, ritualistic behaviours or mental acts
mindfulness-based cognitive therapy (MBCT) is a well-established Mindfulness-Based Interventions (MBIs) that was designed as a group therapy for depressive relapse prevention, integrates teaching mindfulness skills with psychoeducation, strategies and exercises drawn from cognitive behavioural therapy (CBT) for depression [31].Two recent RCTs of MBCT adapted for Obsessive-Compulsive Disorder (OCD) as an augmentation therapy for Cognitive behavioural therapy (CBT) showed small benefits relative to waitlist controls [27] and psychoeducation [28]
This paper reports on two qualitative studies that explored patient perspectives on the acceptability and potential benefits of MBIs for OCD, MB-Exposure and Response (ERP) [49] and MBCT adapted for OCD (MBCT-OCD)

Summary

Introduction

Obsessive-compulsive disorder (OCD) is a debilitating mental health condition characterised by persistent intrusive thoughts, images or urges that cause significant anxiety or discomfort, and repetitive, ritualistic behaviours (e.g. hand washing) or mental acts Participant perspectives on the acceptability and effectiveness of mindfulness-based CBT approaches for OCD data management team

Methods

Results

Conclusion