Values-Focused Exposure and Response Prevention in the Treatment of Comorbid Schizophrenia and Obsessive-Compulsive Disorder: The Case of "Mr. H"

Abstract

We describe a subgroup of individuals with comorbid diagnoses of paranoid schizophrenia and obsessive-compulsive (OCD) disorder.  It is proposed that traditional exposure and response prevention (ERP) may need to be altered given the unique characteristics of this subgroup.  We suggest that providers may approach treatment for OCD from within the context of a patient’s delusion.  The case study of "Mr. H," a veteran of the U.S. military diagnosed with schizophrenia and OCD, is described.  We propose that attenuating or eliminating obsessions and compulsions may not result in the achievement of a goal stemming from a delusional belief, but may contribute to an increased sense of mastery and independence.