Mindfulness- and Acceptance-Based Behavior Therapy for Obsessive-Compulsive Disorder

Abstract

Obsessive-compulsive disorder (OCD) is a chronic anxiety disorder, marked by recurrent, intrusive, and distressing thoughts (obsessions) and/or repetitive behaviors (compulsions). Behavioral interventions for OCD have taken many forms over the past three decades. For the purpose of this chapter, we categorize these treatments into two broad categories: those that emphasize controlling one's unwanted or unpleasant thoughts or feelings (private events), and those that de-emphasize control of private events. In general, control-based strategies such as relaxation training and thought stopping have not been found effective for OCD. We present acceptance and mindfulness not as distinct interventions, but rather as a means of delivering the principles of exposure and response prevention (ERP) in a "user-friendly" and theoretically coherent manner. The role of acceptance and mindfulness in OCD treatment, of course, will ultimately need to be determined at an empirical level. It would be helpful to compare the efficacy of acceptance-based treatments with that of existing treatments such as ERP and cognitive therapy. Furthermore, it would be important to determine whether the mechanisms of change are the same in each of these forms of treatment. Alternatively, in keeping with the spirit of this chapter in which we define acceptance and mindfulness as helpful adjuncts to ERP, it would be informative to study whether the efficacy (as well as factors such as ease of use, tolerability, attrition rate, etc.) of ERP is augmented by acceptance-based strategies. (PsycINFO Database Record (c) 2012 APA, all rights reserved)(chapter)