title: Schema therapy augmented exposure and response prevention in patients with obsessive-compulsive disorder: Feasibility and efficacy of a pilot study.
abstract: In spite of the availability of effective treatments for obsessive-compulsive disorder (OCD), many patients do not respond sufficiently or relapse. Treatments using other potentially effective methods such as experiential techniques need to be investigated. We developed a 12-week inpatient treatment augmenting exposure and response prevention (ERP) with schema therapy (ST) called STERP. The feasibility and effectiveness of STERP was tested..
  
  
  
  In a pilot study, 10 inpatients with OCD who failed to respond to Cognitive Behavioral Therapy (CBT) with ERP received STERP. The Yale-Brown Obsessive Compulsive Scale (Y-BOCS) served as primary outcome. Secondary outcome measures were the Obsessive Compulsive Inventory-revised (OCI-R) and the Beck Depression Inventory (BDI-II). Treatment effects were assessed with t-tests for paired samples.
  
  
  
  Significant reductions of the Y-BOCS, OCI-R and the BDI-II were found, with very large effect sizes (Cohen's d = 1.48-2.25). Results remained stable at 6 months follow-up. Five prior non-responders responded according to the 35% Y-BOCS symptom reduction criterion..
  
  
  
  Lack of control group, small sample size and lack of repeated outcome measures during baseline.
  
  
  
  STERP may be a feasible and potentially effective treatment for prior non-responders among OCD patients and thus worth further investigation in randomized controlled trials..
authors.affiliation: Department of Psychiatry and Psychotherapy, University Medical Center Freiburg, Hauptstrasse 5, 79104 Freiburg, Germany. Electronic address: nicola.thiel@uniklinik-freiburg.de.
authors.forename: Nicola
authors.initials: N
authors.lastname: Thiel
authors.affiliation: Department of Clinical Psychology and Psychotherapy, University of Freiburg, Engelbergerstrasse 41, 79106 Freiburg, Germany; GAIA AG, Hamburg, Germany. Electronic address: gitta.jacob@gaia-group.com.
authors.forename: Gitta A
authors.initials: GA
authors.lastname: Jacob
authors.affiliation: Department of Clinical Psychology and Psychotherapy, University of Freiburg, Engelbergerstrasse 41, 79106 Freiburg, Germany. Electronic address: tuschen@psychologie.uni-freiburg.de.
authors.forename: Brunna
authors.initials: B
authors.lastname: Tuschen-Caffier
authors.affiliation: Department of Psychiatry and Psychotherapy, University Medical Center Freiburg, Hauptstrasse 5, 79104 Freiburg, Germany. Electronic address: nirmal.herbst@arcor.de.
authors.forename: Nirmal
authors.initials: N
authors.lastname: Herbst
authors.affiliation: Department of Psychiatry and Psychotherapy, University Medical Center Freiburg, Hauptstrasse 5, 79104 Freiburg, Germany. Electronic address: Anne.Katrin.Kuelz@uniklinik-freiburg.de.
authors.forename: Anne Katrin
authors.initials: AK
authors.lastname: Külz
authors.affiliation: Department of Psychiatry and Psychotherapy, University Medical Center Freiburg, Hauptstrasse 5, 79104 Freiburg, Germany. Electronic address: Elisabeth.Hertenstein@uniklinik-freiburg.de.
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Hertenstein
authors.affiliation: Department of Psychiatry and Psychotherapy, University Medical Center Freiburg, Hauptstrasse 5, 79104 Freiburg, Germany.
authors.forename: Christoph
authors.initials: C
authors.lastname: Nissen
authors.affiliation: Department of Psychiatry and Psychotherapy, University Medical Center Freiburg, Hauptstrasse 5, 79104 Freiburg, Germany; Schoen Clinic Roseneck, Am Roseneck 6, 83209 Prien am Chiemsee, Germany. Electronic address: UVoderholzer@Schoen-Kliniken.de.
authors.forename: Ulrich
authors.initials: U
authors.lastname: Voderholzer
mesh_terms: D000328:Adult; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009771:Obsessive-Compulsive Disorder / Q000517:prevention & control*; D010865:Pilot Projects; D011569:Psychiatric Status Rating Scales; D016896:Treatment Outcome; D055815:Young Adult
keywords: Cognitive behavior therapy; Exposure and response prevention; Obsessive-compulsive disorder; Schema therapy