Exposure and response prevention (EX/RP) is an evidence-based treatment for obsessive-compulsive disorder (OCD). For EX/RP to be maximally effective, it is believed that patients must adhere outside of sessions to the procedures they learn in therapy. To date, there is no standard measure of patient EX/RP adherence, despite the importance of accurately assessing EX/RP adherence in both clinical research and practice. This paper describes the development of the Patient EX/RP Adherence Scale (PEAS), which assesses the patient's between-session adherence to the therapist's EX/RP instructions, and presents initial data on the scale's reliability and validity. The scale was designed to focus on the key procedures of EX/RP and to be brief enough to be used at each treatment session. The scale demonstrates excellent interrater reliability and good face and content validity. The usefulness of the scale is considered in the context of being an important tool to researchers trying to understand and improve outcomes of EX/RP for OCD as well as to EX/RP therapists in clinical practice. Future research will need to test the scale's reliability and validity in a larger sample of patients over the course of treatment.
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http://dx.doi.org/10.1016/j.beth.2008.12.002 | DOI Listing |
BMC Psychiatry
April 2024
Department of Psychiatry, Møre og Romsdal Hospital Trust, Molde Hospital, Molde, 6412, Norway.
Background: Exposure and response prevention (ERP) is considered the first-line psychotherapy for obsessive-compulsive disorder (OCD). Substantial research supports the effectiveness of ERP, yet a notable portion of patients do not fully respond while others experience relapse. Understanding poor outcomes such as these necessitates further research.
View Article and Find Full Text PDFJ Obsessive Compuls Relat Disord
October 2023
New York State Psychiatric Institute, New York, NY USA.
Exposure and response prevention (EX/RP) can be delivered as monotherapy or to augment serotonin reuptake inhibitors (SRIs). While both options are considered effective OCD treatments, responses are heterogenous. Substantial work has investigated EX/RP predictors to account for this variability in responses, with mixed findings.
View Article and Find Full Text PDFFront Psychiatry
July 2021
Marina de Wolfcentrum, Centrum Voor Psychotherapie, GGZ Centraal, Ermelo, Netherlands.
Patients with severe and treatment refractory obsessive compulsive disorder (OCD) are usually referred to a specialized center for intensive residential treatment (IRT), consisting of exposure and response prevention (EX/RP), pharmacotherapy and additional therapies. About 50% of the patients does not respond to IRT. Currently we are not able to predict treatment response.
View Article and Find Full Text PDFFront Psychiatry
June 2021
Department of Psychiatry, Møre og Romsdal Hospital Trust, Molde Hospital, Molde, Norway.
The treatment of choice for obsessive-compulsive disorder (OCD) is exposure and response prevention (EX/RP). Previous studies have demonstrated that treatment adherence predicts treatment outcome for patients with OCD, but there is little knowledge on its role in concentrated exposure treatment for OCD. In the present study, 42 patients received EX/RP treatment using the Bergen 4-day format.
View Article and Find Full Text PDFBehav Res Ther
August 2021
Department of Biostatistics, Mailman School of Public Health, Columbia University, New York, NY, 10032, USA.
Practice guidelines for adults with obsessive-compulsive disorder (OCD) recommend augmenting serotonin reuptake inhibitors (SRIs) with exposure and ritual prevention (EX/RP). However, fewer than half of patients remit after a standard 17-session EX/RP course. We studied whether extending the course increased overall remission rates and which patient factors predicted remission.
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