title: A randomized clinical trial of a brief family intervention to reduce accommodation in obsessive-compulsive disorder: a preliminary study.
abstract: Accommodation consists of changes in family members' behavior to prevent or reduce patients' obsessive-compulsive disorder (OCD) rituals or distress. High levels of family accommodation are associated with more severe symptoms and functional impairment in patients, and may also interfere with exposure-based treatment. The purpose of this study was to develop and test an intervention to reduce accommodation in the family members of adult OCD patients. Patients (N=18, mean age=35.44, 33% male, 94% Caucasian) received a course of standard individual exposure and ritual prevention (ERP) for OCD. Family members (N=18, mean age=41.72, 56% male, 94% Caucasian) were randomized to either receive or not receive the adjunctive intervention, consisting of two sessions of psychoeducation and skills training in reducing accommodation. Results revealed that the intervention successfully reduced scores on the clinician-rated Family Accommodation Scale (Week 8: d=1.05). Patients whose family members received the intervention showed greater reductions in Yale-Brown Obsessive-Compulsive Scale scores across treatment than patients whose family members had not (Week 8: d=1.27), and hierarchical regression analyses revealed that change in family accommodation from baseline accounted for a significant amount of variance in later OCD symptoms (β=.45, p=.02). Results from this preliminary study suggest that adjunctive intervention produces more rapid treatment response compared with traditional ERP alone. Accommodation is a potentially important target for improving treatment in OCD and other diagnostic groups where accommodation is likely to occur.
authors: Boston University. Electronic address: hollands@bu.edu.
authors: Johanna
authors: J
authors: Thompson-Hollands
authors: Massachusetts General Hospital, Harvard Medical School.
authors: Amitai
authors: A
authors: Abramovitch
authors: Boston University.
authors: Martha C
authors: MC
authors: Tompson
authors: Boston University.
authors: David H
authors: DH
authors: Barlow
mesh_terms: D000328:Adult; D001521:Behavior Therapy / Q000379:methods*; D005190:Family / Q000523:psychology; D005195:Family Relations; D005260:Female; D006801:Humans; D008297:Male; D009771:Obsessive-Compulsive Disorder / Q000175:diagnosis / Q000628:therapy*; D012044:Regression Analysis; D016896:Treatment Outcome
keywords: accommodation; family; obsessive–compulsive disorder
references: J Anxiety Disord. 2014 Dec;28(8):765-73
references: 25261837
references: J Consult Clin Psychol. 1991 Feb;59(1):12-9
references: 2002127
references: Clin Psychol Rev. 2007 Jun;27(5):572-81
references: 17343963
references: J Nerv Ment Dis. 1999 Oct;187(10):636-42
references: 10535658
references: J Abnorm Psychol. 2001 Feb;110(1):49-58
references: 11261399
references: J Consult Clin Psychol. 2009 Apr;77(2):355-60
references: 19309195
references: Psychol Assess. 2002 Dec;14(4):485-96
references: 12501574
references: Psychol Assess. 2009 Sep;21(3):256-71
references: 19719339
references: J Anxiety Disord. 2006;20(8):1016-35
references: 16621437
references: J Am Acad Child Adolesc Psychiatry. 2011 Nov;50(11):1149-61
references: 22024003
references: J Fam Psychol. 2014 Jun;28(3):287-98
references: 24798816
references: Psychiatr Clin North Am. 2000 Sep;23(3):509-17
references: 10986724
references: Psychopharmacology (Berl). 1998 Apr;136(3):205-16
references: 9566805
references: Ann Clin Psychiatry. 2008 Apr-Jun;20(2):65-70
references: 18568577
references: J Anxiety Disord. 2000 May-Jun;14(3):209-17
references: 10868980
references: Behav Res Ther. 2009 Jan;47(1):18-25
references: 19026405
references: Behav Res Ther. 2013 Jun;51(6):316-22
references: 23567474
references: Behav Ther. 2012 Sep;43(3):666-78
references: 22697453
references: Psychol Assess. 2010 Jun;22(2):223-32
references: 20528050
references: J Clin Child Adolesc Psychol. 2007 Apr-Jun;36(2):207-16
references: 17484693
references: Br J Psychiatry. 1996 Jul;169(1):101-7
references: 8818377
references: J Consult Clin Psychol. 1988 Dec;56(6):893-7
references: 3204199
references: Expert Rev Neurother. 2012 Feb;12(2):229-38
references: 22288678
references: Cogn Behav Ther. 2005;34(3):164-75
references: 16195055
references: J Am Acad Child Adolesc Psychiatry. 2008 May;47(5):593-602
references: 18356758
references: J Am Acad Child Adolesc Psychiatry. 2008 Oct;47(10):1173-81
references: 18724255
references: J Anxiety Disord. 1997 Jul-Aug;11(4):431-46
references: 9276786
references: Cogn Behav Pract. 2010 Feb;17(1):88-101
references: 33762811
references: J Anxiety Disord. 2010 Mar;24(2):275-83
references: 20056376
references: Depress Anxiety. 2008;25(12):1020-7
references: 18833578
references: Depress Anxiety. 2013 Jan;30(1):47-54
references: 22965863
references: J Abnorm Child Psychol. 2012 Jan;40(1):133-43
references: 21842196
references: Mol Psychiatry. 2010 Jan;15(1):53-63
references: 18725912