OUTPATIENT, MULTIMODAL BEHAVIOR-THERAPY FOR OBSESSIVE-COMPULSIVE DISORDER

Background With regard to long-term outcome, behaviour therapy is the first choice treatment for obsessive-compulsive disorder (OCD), with o r without concomitant selective serotonin reuptake inhibitor (SSRI) me dication. Yet, results from research trials, usually restricted to exp osure with response-preventions and other symptom-directed techniques, may not be generalisable to people with OCD in community health care services. Method For more than 20 years we have delivered out-patient behaviour therapy to unselected people with OCD from the community, in cluding those with motivational and compliance problems. Prospective-r etrospective follow-ups were carried out from 1-13 years after treatme nt. Results This paper describes the applied multi-modal, strategic-sy stemic behaviour therapy, and our partially new model of OCD. Complian t patients achieved the usual success rate of 65-70%, but-this drops t o 50% if all patients treated are included in the analysis. Conclusion s For major subgroups of OCD, behaviour therapy is a very effective tr eatment modality. Exposure is essential, but additional ('causal') int erventions are equally important in about half of the patients from un selected samples. Both behaviour therapy and drug-treatments need to b e improved and predictive variables for outcome of either of them are urgently needed.