The treatment of obsessive‐compulsive checking: A randomised trial comparing danger ideation reduction therapy with exposure and response prevention

Abstract

Standard psychological treatment of obsessive‐compulsive disorder (OCD) typically involves the behavioural‐based therapy exposure and response prevention (ERP). This study compared the effectiveness of ERP with the recently developed cognitive therapy‐based treatment package, Danger Ideation Reduction Therapy for obsessive‐compulsive checkers (DIRT‐C) (Vaccaro, Jones, Menzies, and St Clare). Both treatments were delivered in 14 1‐hr individual weekly sessions. Post‐treatment intention‐to‐treat analysis revealed large statistically significant improvements for participants in both ERP (n = 22) and DIRT‐C (n = 28) conditions. However, treatment effect sizes for change in OCD symptom severity at post‐treatment were greater for DIRT‐C than for ERP (3.74 versus 2.89). In addition, at post‐treatment assessment, significantly more participants who received DIRT‐C were recovered compared with those who received ERP (43% versus 14%). Similarly, at 6‐month follow‐up, treatment effect sizes for change in OCD symptom severity were greater for DIRT‐C than for ERP (3.9 versus 2.76). This study provides further evidence of the usefulness of the DIRT‐C package for people with OCD checking subtype. Future research investigating DIRT‐C is warranted.