title: Adding motivational interviewing to exposure and ritual prevention for obsessive-compulsive disorder: an open pilot trial.
abstract: Exposure and ritual prevention (EX/RP) is an efficacious treatment for obsessive-compulsive disorder (OCD), but high dropout rates and variable treatment adherence limit its effectiveness. Motivational interviewing (MI) has shown promise as an adjunct to symptom-focused treatments for improving treatment adherence and outcomes. The authors developed a manual integrating MI with EX/RP, consisting of three information-gathering/motivational enhancement sessions and 15 EX/RP sessions with an optional MI module to be used as needed. Six patients with moderate to severe OCD symptoms (Yale-Brown Obsessive Compulsive Scale [Y-BOCS] score> or =16) underwent treatment. Five showed a decrease in their baseline Y-BOCS scores and an increase in their quality of life, with three achieving an excellent response (i.e. Y-BOCS< or =12 at Session 18). The authors briefly describe the motivational strategies used in the six cases and suggest that integrating MI with standard EX/RP is a promising method to increase and sustain patient engagement with EX/RP. Challenges in combining these treatments and maintaining the integrity of each as well as limitations of the study are discussed.
authors: Anxiety Disorders Clinic, New York State Psychiatric Institute, New York, NY, USA. simpson@nyspi.cpmc.columbia.edu
authors: Helen Blair
authors: HB
authors: Simpson
authors: Allan
authors: A
authors: Zuckoff
authors: Jessica R
authors: JR
authors: Page
authors: Martin E
authors: ME
authors: Franklin
authors: Edna B
authors: EB
authors: Foa
mesh_terms: D000328:Adult; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D007406:Interview, Psychological; D008297:Male; D008875:Middle Aged; D009042:Motivation; D009771:Obsessive-Compulsive Disorder / Q000523:psychology / Q000628:therapy*; D010349:Patient Compliance / Q000523:psychology; D010865:Pilot Projects; D011788:Quality of Life