Patients with obsessive-compulsive disorder who participate in a motivational interviewing (MI) intervention before treatment with exposure and response prevention (ERP) get better short-term results, compared with those who participate in a relaxation intervention before ERP, a small study shows.
“These findings suggest that MI prior to ERP may confer a small but meaningful benefit for enhancing treatment outcome post ERP,” wrote Randi E. McCabe, PhD, of the department of psychiatry and behavioral neurosciences at McMaster University, Hamilton, Ont., and associates. The study was published in the Journal of Obsessive-Compulsive and Related Disorders.
Dr. McCabe and associates randomized 40 patients aged 18-65 years to the MI intervention and relaxation groups. All participants had a diagnosis of OCD as defined by the Structured Clinical Interview for DSM-IV. They also scored 16 or higher on the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) and said they were interested in the ERP treatment. After a few participants dropped out, 18 were left in the MI group and 17 were in the relaxation group.
The MI intervention consisted of three sessions that focused on raising awareness about the emotional and financial impact of the illness on patients’ lives, and addressing their concerns about ERP – which is a form of cognitive-behavioral therapy tailored to meet the needs of people with OCD. Meanwhile, the relaxation therapy was a three-session protocol consisting of progressive muscle relaxation.
Participants in both groups experienced reductions in symptoms in the short term, but the symptom reductions were more significant for participants in the MI group. For example, Y-BOCS scores were significantly lower among participants in the MI group posttreatment, compared with those in the relaxation intervention (13.72 vs. 16.20 at 3-month follow-up and 13.81 vs. 14.00 at 6-month follow-up). “Whereas Y-BOCS scores decreased from the severe range to the moderate range in the relaxation group, scores decreased from the severe to the mild range in the MI group,” the investigators wrote. Similar trends were found on other measures, including the DASS-21 depression scale and the DASS-21 anxiety stress scale. At the 12-month follow-up, however, “both groups looked similar,” Dr. McCabe and associates reported.
Several limitations were cited, including the small study size and the baseline differences in the participants’ self-reported OCD symptoms.
Nevertheless, the results suggest that intervening with they wrote.
Dr. McCabe and her associates reported no disclosures.
SOURCE: McCabe RE et al. J Obsessive Compuls Relat Disord. 2019. doi: 10.1016/j.jocrd.2019.1004466.