Frequency and level of self-efficacy predict the effectiveness of therapist- and self-guided exposure in obsessive compulsive disorder

• Published in: Behavioural and cognitive psychotherapy Vol. 48; no. 6; pp. 751 - 755
• Main Authors: Voderholzer, Ulrich, Hilbert, Sven, Fischer, Anne, Neumüller, Jakob, Schwartz, Caroline, Hessler-Kaufmann, Johannes Baltasar
• Format: Journal Article
• Language: English
• Published: Cambridge, UK Cambridge University Press 01.11.2020
• Subjects: Brief Clinical Report; Hypotheses; Mediation; Obsessive compulsive disorder; Patients; Regression analysis; Response prevention; Self-efficacy; Substance abuse treatment; Therapy; mediation; cognitive behaviour therapy; exposure; obsessive compulsive disorder; self-efficacy
• ISSN: 1352-4658; 1469-1833
• DOI: 10.1017/S1352465820000582

Abstract Background: While exposure and response prevention (ERP) is the most effective treatment for obsessive compulsive disorder (OCD), less is known about the specific mechanisms underlying symptom change after ERP. Aims: We tested the hypothesis that the frequency of self- and therapist-guided ERP related to the extent of symptom reduction and that this link is mediated by increased self-efficacy. Method: In a sample of 377 in-patients with a primary diagnosis of OCD receiving in-patient CBT, we assessed symptoms (YBOCS-SR) and self-efficacy (General Self-Efficacy Scale), before and after treatment, as well as the frequency of therapist- and self-guided ERP sessions. Results: Patients with more therapist-guided ERP sessions during treatment showed more symptom reduction and the association of self-guided ERP on outcome was mediated by enhanced self-efficacy. Conclusions: These findings highlight the importance of both therapist- and self-guided ERP sessions and suggest that therapists should conduct a sufficient number of ERP sessions to optimise treatment.