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Frequency and level of self-efficacy predict the effectiveness of therapist- and self-guided exposure in obsessive compulsive disorder

Published online by Cambridge University Press:  20 August 2020

Ulrich Voderholzer
Affiliation:
University of Freiburg, Department for Psychiatry and Psychotherapy, Hauptstrasse 5, 79104Freiburg, Germany Schön Clinic Roseneck, Am Roseneck 6, 83209Prien am Chiemsee, Germany
Sven Hilbert
Affiliation:
University of Munich (LMU), Department of Methodology and Diagnostics, Leopoldstrasse 13, 80802Munich, Germany
Anne Fischer
Affiliation:
University of Munich (LMU), Department of Methodology and Diagnostics, Leopoldstrasse 13, 80802Munich, Germany
Jakob Neumüller
Affiliation:
University of Munich (LMU), Department of Psychiatry and Psychotherapy, Nußbaumstrasse 7, 80336Munich, Germany
Caroline Schwartz
Affiliation:
University of Munich (LMU), Department of Psychiatry and Psychotherapy, Nußbaumstrasse 7, 80336Munich, Germany
Johannes Baltasar Hessler-Kaufmann*
Affiliation:
Schön Clinic Roseneck, Am Roseneck 6, 83209Prien am Chiemsee, Germany University of Munich (LMU), Department of Psychiatry and Psychotherapy, Nußbaumstrasse 7, 80336Munich, Germany
*
*Corresponding author. Email: Johannes.hessler@med.uni-muenchen.de

Abstract

Background:

While exposure and response prevention (ERP) is the most effective treatment for obsessive compulsive disorder (OCD), less is known about the specific mechanisms underlying symptom change after ERP.

Aims:

We tested the hypothesis that the frequency of self- and therapist-guided ERP related to the extent of symptom reduction and that this link is mediated by increased self-efficacy.

Method:

In a sample of 377 in-patients with a primary diagnosis of OCD receiving in-patient CBT, we assessed symptoms (YBOCS-SR) and self-efficacy (General Self-Efficacy Scale), before and after treatment, as well as the frequency of therapist- and self-guided ERP sessions.

Results:

Patients with more therapist-guided ERP sessions during treatment showed more symptom reduction and the association of self-guided ERP on outcome was mediated by enhanced self-efficacy.

Conclusions:

These findings highlight the importance of both therapist- and self-guided ERP sessions and suggest that therapists should conduct a sufficient number of ERP sessions to optimise treatment.

Type
Brief Clinical Report
Copyright
© British Association for Behavioural and Cognitive Psychotherapies 2020

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