Intensive Cognitive Behavioural Therapy for Obsessive Compulsive Disorder: Perspectives of Service Users

Abstract

Background: The National Institute for Health and Care Excellence (NICE) recommend an intensive version of treatment for service users who have not responded to > 2 treatments for Obsessive Compulsive Disorder (OCD). The views of service users for whom this format of treatment is recommended are unknown. Method: Thirty semi-structured telephone interviews were conducted with participants with OCD. All participants had previously undertaken > 2 unsuccessful courses of CBT. Interviews were analysed using reflexive thematic analysis. Results: Participants reported that an intensive format may provide the time required to tackle important aspects of therapy that were not achieved or tackled during weekly CBT (e.g. in-session ERP). Individual preference is seen to play an important role and consequently an intensive format will not be well-suited to all who have experienced previous CBT failure. Four themes were identified: 1) Continuity and momentum, 2) Hmm, yes, but…: reservations about intensive CBT, 3) The fortune is in the follow-up, and 4) Understanding individual preference. Conclusion: Findings support the NICE recommendation. Participants with OCD who had experienced multiple CBT failures perceived intensive CBT to be broadly acceptable with potential therapeutic advantages. Reservations related to the possibility of relapse after therapy were expressed. Clinical implications and future research directions are discussed.