Frequency and level of self-efficacy predict the effectiveness of therapist- and self-guided exposure in obsessive compulsive disorder.
Authors: Voderholzer U, Hilbert S, Fischer A, Neumüller J, Schwartz C, Hessler-Kaufmann JB
Journal: Behavioural and cognitive psychotherapy
cognitive behaviour therapy
exposure
mediation
obsessive compulsive disorder
self-efficacy
Allied Health Personnel
Cognitive Behavioral Therapy
Humans
Obsessive-Compulsive Disorder
Self Efficacy
Treatment Outcome
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.