Concentrated ERP delivered in a group setting: An effectiveness study

Havnen, Audun; Hansen, Bjarne; Öst, Lars‐Göran; Kvale, Gerd

doi:10.1016/j.jocrd.2014.08.002

Cited by 39 publications

(73 citation statements)

References 26 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Before treatment, the patients with sleep disturbance did not differ from OCD‐patients without sleep disturbance with regard to the severity of the OCD symptoms, self‐reported depressive symptoms or other potentially important variables, including medication. In accordance with our previous research (Havnen et al ., ) the cET was effective in producing clinical change in OCD‐symptoms.…”

Section: Discussionmentioning

confidence: 91%

“…For a detailed description of the treatment procedure and the cET‐format, see Havnen, Hansen, Haug, Prescott, and Kvale () and Havnen et al . ().…”

Section: Methodsmentioning

confidence: 97%

“…Patients who did not fulfill diagnostic criteria for OCD were further referred to their respective psychiatric clinic in the county. Prior to treatment patients received one session of psychoeducation focusing on how OCD is maintained by ritualistic behaviours and avoidance, and psychoeducation about the treatment principles (Havnen, Hansen, Öst & Kvale, ).…”

Section: Methodsmentioning

confidence: 99%

“…The 4-day cET-treatment does not include any specific sleep interventions. For a detailed description of the treatment procedure and the cET-format, see Havnen, Hansen, Haug, Prescott, and Kvale (2013) and Havnen et al (2014).…”

Section: Treatment Proceduresmentioning

confidence: 99%

See 3 more Smart Citations

Sleep disturbances in treatment‐seeking OCD‐patients: Changes after concentrated exposure treatment

Nordahl

Havnen

Hansen

et al. 2017

Scandinavian J Psychology

Self Cite

View full text Add to dashboard Cite

Research indicates that patients with Obsessive Compulsive Disorder (OCD) frequently suffer from comorbid sleep difficulties, and that these difficulties often are not clinically recognized and diagnosed. There has been limited research investigating if comorbid sleep difficulties impair treatment outcome for OCD and if the sleep difficulties change following OCD-treatment. Thirty-six patients with obsessive compulsive disorder underwent concentrated exposure treatment delivered in a group over four consecutive days and were assessed with measures of OCD, depressive symptoms and sleep disturbance at three different time points (pre, post and 6 months follow-up). The sample was characterized by a high degree of comorbidity with other psychiatric disorders. At pre-treatment nearly 70% of the patients reported sleep difficulties indicative of primary insomnia. The results showed that patients had large reductions of OCD-symptoms as well as significant improvements in sleep disturbance assessed after treatment, and that these improvements were maintained at follow-up. Sleep disturbance did not impair treatment outcome, on the contrary patients with higher degree of sleep disturbance at pre-treatment had better outcome on OCD-symptoms after treatment. The results indicated that the majority of the OCD sample suffered from sleep disturbances and that these sleep disturbances were significantly reduced following adequate treatment of OCD without specific sleep interventions. However, a proportion of the patients suffered from residual symptoms of insomnia after treatment.

show abstract

Section: Discussionmentioning

confidence: 91%

“…For a detailed description of the treatment procedure and the cET‐format, see Havnen, Hansen, Haug, Prescott, and Kvale () and Havnen et al . ().…”

Section: Methodsmentioning

confidence: 97%

Section: Methodsmentioning

confidence: 99%

Section: Treatment Proceduresmentioning

confidence: 99%

See 2 more Smart Citations

Sleep disturbances in treatment‐seeking OCD‐patients: Changes after concentrated exposure treatment

Nordahl

Havnen

Hansen

et al. 2017

Scandinavian J Psychology

Self Cite

View full text Add to dashboard Cite

show abstract

“…Hence, there might be an added benefit to combine a group setting with one-to-one contact between a therapist and a patient. One RCT in adults with OCD shows the benefits of an individually delivered intensive E/RP in a group setting [95].…”

Section: Modified Cbtmentioning

confidence: 99%

Evidence-Based Treatments in Treatment-Naïve and Treatment-Resistant Pediatric Obsessive-Compulsive Disorder

Skarphéðinsson

Ivarsson

2015

Curr Behav Neurosci Rep

View full text Add to dashboard Cite

Pediatric obsessive-compulsive disorder (OCD) is a chronic, disabling, and common disorder. In this paper, we describe evidence-based treatments in treatment-naïve and treatment-refractory pediatric OCD patients. We conducted a PubMed search to identify randomized controlled trials, reviews, and expert guidelines. The evidence for cognitive behavior therapy (CBT) and specific serotonin reuptake inhibitors (SSRIs) among treatment-naïve patients is substantial and shows that both treatments are effective. Head-to-head trials in pediatric OCD only show that CBT is significantly more effective than SSRI. The evidence among CBT and SSRI non-responders is limited. One trial among CBT non-responders showed that both continued CBT and switching to an SSRI are effective strategies. Likewise, one trial among SSRI non-responders showed that augmenting with CBT is necessary. Evidence of treatments for treatment-refractory pediatric OCD is lacking. We describe the treatments available and evidence from studies of adult OCD. Evidence for emerging treatments such as modifying CBT and glutamatergic drugs is also described.

show abstract

Effect of D-Cycloserine on the Effect of Concentrated Exposure and Response Prevention in Difficult-to-Treat Obsessive-Compulsive Disorder

et al. 2020

Self Cite

View full text Add to dashboard Cite

IMPORTANCE Evidence is lacking for viable treatment options for patients with difficult-to-treat obsessive-compulsive disorder (OCD). It has been suggested that D-cycloserine (DCS) could potentiate the effect of exposure and response prevention (ERP) treatment, but the hypothesis has not been tested among patients with difficult-to-treat OCD. OBJECTIVE To evaluate whether DCS potentiates the effect of concentrated ERP among patients with difficult-to-treat OCD. DESIGN, SETTING, AND PARTICIPANTS The study was a randomized placebo-controlled triplemasked study with a 12-month follow-up. Participants were adult outpatients with difficult-to-treat OCD. A total of 220 potential participants were referred, of whom 36 did not meet inclusion criteria and 21 declined to participate. Patients had either relapsed after (n = 100) or not responded to (n = 63) previous ERP treatment. A total of 9 specialized OCD teams within the public health care system in Norway participated, giving national coverage. An expert team of therapists from the coordinating site delivered treatment. Inclusion of patients started in January 2016 and ended in August 2017. Data analysis was conducted February to September 2019. INTERVENTIONS All patients received individual, concentrated ERP treatment delivered during 4 consecutive days in a group setting (the Bergen 4-day treatment format) combined with 100 mg DCS, 250 mg DCS, or placebo. MAIN OUTCOMES AND MEASURES Change in symptoms of OCD and change in diagnostic status. Secondary outcomes measures included self-reported symptoms of OCD, anxiety, depression, and quality of life. RESULTS The total sample of 163 patients had a mean (SD) age of 34.5 (10.9) years, and most were women (117 [71.8%]). They had experienced OCD for a mean (SD) of 16.2 (10.2) years. A total of 65 patients (39.9%) were randomized to receive 100 mg DCS, 67 (41.1%) to 250 mg of DCS, and 31 (19.0%) to placebo. Overall, 91 (56.5%) achieved remission at posttreatment, while 70 (47.9%) did so at the 12-month follow-up. There was no significant difference in remission rates among groups. There was a significant reduction in symptoms at 12 months, and within-group effect sizes ranged from 3.01 (95% CI, 2.38-3.63) for the group receiving 250 mg DCS to 3.49 (95% CI, 2.78-4.18) for the group receiving 100 mg DCS (all P < .001). However, there was no significant effect of treatment group compared with placebo in obsessive-compulsive symptoms (250 mg group at posttreatment: d = 0.33; 95% CI, −0.10 to 0.76; 100 mg group at posttreatment: d = 0.36; 95% CI, −0.08 to 0.79), symptoms of depression and anxiety (eg, Patient Health Questionnaire-9 score among 250 mg (continued) Key Points Question Does D-cycloserine potentiate the effect of concentrated exposure and response prevention in difficult-to-treat obsessive-compulsive disorder? Findings In this randomized clinical trial of 163 participants, D-cycloserine did not significantly affect treatment outcomes. Most patients responded to the concentrated exposure and response prevention treatme...

show abstract

Concentrated ERP delivered in a group setting: An effectiveness study

Cited by 39 publications

References 26 publications

Sleep disturbances in treatment‐seeking OCD‐patients: Changes after concentrated exposure treatment

Sleep disturbances in treatment‐seeking OCD‐patients: Changes after concentrated exposure treatment

Evidence-Based Treatments in Treatment-Naïve and Treatment-Resistant Pediatric Obsessive-Compulsive Disorder

Effect of D-Cycloserine on the Effect of Concentrated Exposure and Response Prevention in Difficult-to-Treat Obsessive-Compulsive Disorder

Contact Info

Product

Resources

About