A long-term follow-up of group behavioral treatment for obsessive-compulsive disorder in Norway. A quantitative and qualitative study.
This symposium will deal with a Norwegian 8 year (in average) follow-up of group behavioral therapy for obsessive-compulsive disorder. In the first paper the long-term effectiveness of group CBT will be presented. In the second paper fifteen of these OCD patients were asked in a qualitative study about what they learned from the group ERP and how they dealt with the OCD symptom variations over time. In the third paper the same 15 patients were were interviewed in focus groups about their understanding of why they developed OCD and what they thought about the significance of having such an explanation.
Convenor: Åshild Tellefsen Håland
- Tor sunde: A long-term follow-up of group behavioral therapy for obsessive-compulsive disorder in a general outpatient clinic in Norway.
- Liv Tveit Walseth: Self-Management of Obsessive-Compulsive Disorder in the Long-Term after Therapy – A Focus group Interview
- Åshild Tellefsen Haaland: The patients understanding of why they developed obsessive compulsive disorder. A qualitative study.
1. Presenter: Tor Sunde
There is a lack of knowledge regarding the long-term effect of evidence-based CBT/ ERP treatment for OCD that is delivered in routine clinical care. The aim of this study was to examine the long-term effectiveness of behavioral treatment for OCD in a Norwegian general outpatient clinic. In the current study, 62% (N = 40) of the original patients treated in a previously published study of group ERP for OCD were re-evaluated an average of eight years after completing the original treatment. This is the longest follow-up study that has been conducted for OCD patients treated with group ERP. There was a significant reduction in symptoms from pre- to post-treatment measured with the Yale-Brown Obsessive Compulsive Scale (Y-BOCS), the Spielberger State Anxiety Inventory (STAI-S) and the Beck Depression Inventory (BDI). The gains were maintained from post-treatment through long-term follow-up. Fifty percent of the participants experienced either a clinically significant improvement (10%) or recovery (40%) in OCD symptoms at long-term follow-up. This suggests that patients receiving general outpatient mental health clinic based group ERP for OCD maintain gains over the long-term. The aim is to present to the results from this study and discuss the experience with the implementation of the group ERP for OCD in our clinic.
Sunde, Tor; Walseth, Liv Tveit; Himle, Joseph A.; Vogel, Patrick A.; Launes, Gunvor; Haaland, Vegard Øksendal; Hoffart, Asle; Johnson, Sverre Urnes; Haaland, Åshild (2017). A long-term follow-up of group behavioral therapy for obsessive-compulsive disorder in a general outpatient clinic in Norway. Journal of Obsessive-Compulsive and Related Disorders, 59-64
2. Presenter: Liv Tveit Walseth
Effect of OCD treatment is traditionally reported as symptom level at single points in time. The goal of the present qualitative study was to reveal a more multidimensional description of how OCD patients are doing after therapy. Fifteen OCD patients who had received group ERP therapy 6-11 years earlier participated in 3 focus groups. Their present symptom-level of OCD varied from none to severe. They were asked open-ended questions concerning what they learned from the group ERP and how they dealt with the OCD symptom variations over time. The interviews were audiotaped, transcribed, and analysed phenomenologically.
The results showed that the participants had achieved a foundation for a relaxed solution-oriented attitude regarding their OCD, regardless of their symptom level. The foundation for this attitude consisted of a new self-understanding, a higher evaluation of them self, externalizing and devaluating of OCD where OCD compulsions were reduced to symptoms and not as behaviour crucial to their identity, seeing OCD as possible to influence. They used several self-management strategies such as using elements learned from treatment, they took efforts to reduce stress level. and took breaks from routines. Surprisingly, none of the participants used formal ERP as they were taught.
The study constitute valuable experience-based input contributing to the development of a multidimensional assessment tool which can evaluate whether OCD patients have attitudes and strategies that make them able to cope with symptom variations.
Walseth LT, Walseth ÅT, Launes L, Himle J, Håland VØ, Håland ÅT, “Self-Management of Obsessive-Compulsive Disorder in the Long-Term after Therapy – A Focus Group Interview”, European Journal for Person Centered Healthcare, Volum 5, issue 1, 2017
3. Presenter: Åshild Tellefsen Håland
Haaland, Å. T, Launes, G., Haaland, V. Ø., Vogel, P. A., Himle, J. A., Sunde, T & Walseth, L. T.
There is a lack of empirical studies investigating patients conceptualization of why they developed obsesssive compulsive disorder (OCD). In the current study 15 patients with obsessive-compulsive disorder were interviewed in focus groups about their understanding of why they developed OCD and what they thought about the significance of having such an explanation. The interviews were analyzed according to systematic text condensation, which is a modification of Giorgi´s phenomenological method. The data analysis revealed four main categories: First, the majority of the patients conceived the origin for their OCD as a coping strategy to cope with helplessness linked to diverse stressful life events in the past. Second, some patients also viewed their OCD as a result of family heritage and underlying vulnerability in terms of perfectionism and inflated responsibility. Third, several informants emphasized that having an understanding of the meaning behind the symptoms was comforting and strengthen their self-esteem. Fourth, the importance of attending to the origin of OCD in treatment varied among the informants. Some patients suggested that discussion of the causes should be added to CBT, while others preferred not to talk about it. The results and therapeutic implications will be discussed.