Successfully treating 90 patients with obsessive compulsive disorder in eight days: the Bergen 4-day treatment

Abstract

BackgroundOslo University Hospital, Norway, had by autumn 2016, accumulated a waiting list of 101 patients with obsessive-compulsive disorder (OCD) who had a legal right to receive treatment by a specialized OCD team. In this challenging situation, the Bergen OCD-team suggested to solve the problem by offering all patients an option for the rapid Bergen 4-day treatment (B4DT). The B4DT is an individual treatment delivered during four consecutive days in a group of six patients with the same number of therapists. The approach has previously shown a post-treatment response rate of 90% and a 3-month remission rate of 70%.MethodsNinety-seven of the wait-list patients were available for the scheduled time slots, and 90 received the 4-day format during 8 days (45 patients each week). The therapists were recruited from 22 different specialized OCD-teams from all over Norway, and 44 (68%) had not previously delivered the 4-day format.ResultsPost-treatment; 91.1% of the patients were classified as responders, and 72.2% were in remission. At 3-month follow-up; 84.4 were classified as responders and the remission rate was 67.7%. Oslo University Hospital now offers the 4-day treatment as standard treatment for OCD.ConclusionsWe conclude that the B4DT is an acceptable and potentially effective OCD-treatment.

A 4-Day Mindfulness-Based Cognitive Behavioral Intervention Program for CFS/ME. An Open Study, With 1-Year Follow-Up

“…In order to allow the treatment to have full attention, we encouraged the patients to have no other appointments during these days. The 4-day format has, with a different content, been applied for OCD as well as for panic disorder, with highly promising results (46, 47) and low drop-out-rate.…”

Effects of Bergen 4-Day Treatment on Resting-State Graph Features in Obsessive-Compulsive Disorder

“…Havnen et al, 2017;Havnen et al, 2014). The effective transportability of B4DT has also been shown in new clinics in both Norway and Iceland (Davíðsdóttir et al, 2019;Kvale et al, 2018;Launes et al, 2019), and clinics in Sweden and the US are currently being trained to deliver the treatment.…”

“…Effectiveness studies also show that ERP is effective when provided in real-life clinical practice (Franklin, Abramowitz, Kozak, Levitt, & Foa, 2000;Hans & Hiller, 2013;B. Hansen, Kvale, Hagen, Havnen, & Ost, 2018;Kvale et al, 2018). Lastly, various forms of CBT (including ERP, cognitive therapy and metacognitive therapy) all seem to be effective and contain overlapping elements of psychoeducation, exposure, cognitive restructuring, and stopping compulsions and avoidance behaviors (Papageorgiou et al, 2018).…”

Retiring, Rethinking, and Reconstructing the Norm of Once-Weekly Psychotherapy

“…Psychotherapies need not be delivered in a once-weekly format to effect clinical improvement. One intensive outpatient treatment, involving four consecutive days of exposure and response prevention treatment, has substantially reduced OCD symptoms for adults up to 4 years later (Hansen et al 2019 ; Kvale et al 2018 ) and adolescents up to 6 months later (Riise et al 2016 , 2018 ). Other trials indicate that an 8-day, 20-h treatment involving cognitive-behavioral techniques—including interoceptive exposures and psycho-education—can reduce symptoms of specific phobia, social phobia, and GAD (Gallo et al 2012 ).…”