Multifamily Psycho educational Intervention (MPI) for obsessive-compulsive disorder: a pilot study

Albert, Umberto; Maina, Giuseppe; Saracco, Paola; Bogetto, Filippo

doi:10.1017/s1121189x00002050

Cited by 7 publications

(5 citation statements)

References 17 publications

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“…Preliminary evidence also suggests that a multifamily psychoeducational intervention for relatives/caregivers of adult patients currently receiving drug treatment (consisting of both psychoeducation about the disorder and its treatment and skills training in reducing accommodation) is effective in reducing accommodation; 51 our personal experience (data not yet published) is that patients whose family members participated in this multifamily psychoeducational intervention responded better (in terms of global reduction of YBOCS total scores) than the individuals who received only the standard drug treatment.…”

Section: Resultsmentioning

confidence: 99%

Family accommodation in adult obsessive–compulsive disorder: clinical perspectives

Albert¹,

Baffa²,

Maina³

2017

PRBM

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The term accommodation has been used to refer to family responses specifically related to obsessive–compulsive (OC) symptoms: it encompasses behaviors such as directly participating in compulsions, assisting a relative with obsessive–compulsive disorder (OCD) when he/she is performing a ritual, or helping him/her to avoid triggers that may precipitate obsessions and compulsions. At the opposite side, family responses to OCD may also include interfering with the rituals or actively opposing them; stopping accommodating OC symptoms or actively interfering with their performance is usually associated with greater distress and sometimes even with aggressive behaviors from the patients. This article summarizes progress of the recent research concerning family accommodation in relatives of patients with OCD. Family accommodation is a prevalent phenomenon both among parents of children/adolescents with OCD and relatives/caregivers of adult patients. It can be measured with a specific instrument, the Family Accommodation Scale, of which there are several versions available for use in clinical practice. The vast majority of both parents of children/adolescents with OCD and family members of adult patients show at least some accommodation; providing reassurances to obsessive doubts, participating in rituals and assisting the patient in avoidance are the most frequent accommodating behaviors displayed by family members. Modification of routine and modification of activities specifically due to OC symptoms have been found to be equally prevalent. Specific characteristics of patients (such as contamination/washing symptoms) and of relatives (the presence of anxiety or depressive symptoms or a family history positive for another anxiety disorder) are associated with a higher degree of family accommodation; these family members may particularly benefit from family-based cognitive–behavioral interventions. In recent years, targeting family accommodation has been suggested as a fundamental component of treatment programs and several interventions have been tested. Clinicians should be aware that family-based cognitive–behavior therapy incorporating modules to target family accommodation is more effective in reducing OC symptoms. Targeting family accommodation may be as well relevant for patients treated pharmacologically.

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Section: Resultsmentioning

confidence: 99%

Family accommodation in adult obsessive–compulsive disorder: clinical perspectives

Albert¹,

Baffa²,

Maina³

2017

PRBM

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“…Given the strength of the evidence, we do suggest this option especially in patients who showed a partial but unsatisfactory response. An alternative evidence-based strategy is the addition of CBT to pharmacotherapy (Albert and Bogetto 2015), given its superior efficacy and less negative adverse effect profile compared to antipsychotics (Simpson et al, 2013).…”

Section: Summary Of Findings and Discussionmentioning

confidence: 99%

Role and clinical implications of atypical antipsychotics in anxiety disorders, obsessive-compulsive disorder, trauma-related, and somatic symptom disorders

Albert

Carmassi

Cosci

et al. 2016

International Clinical Psychopharmacology

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Atypical antipsychotics (AAs) may play a role in the treatment of anxiety disorders, obsessive-compulsive disorder (OCD), and trauma-related disorders. No reviews on their differential use in these different disorders have been performed recently. The aim of this systematized review was to obtain data on efficacy and comparative effectiveness of AAs as a treatment of anxiety disorders, OCD, and trauma-related disorders to provide guidance for clinicians on when and which AA to use. We searched on PubMed, Psychnet, and Cochrane Libraries from inception to July 2015. Search results were limited to randomized, placebo-controlled trials of adult patients. Evidence of efficacy was considered the presence of positive results in two or more double-blind placebo-controlled studies. Our systematized search identified 1298 papers, of which 191 were subjected to a full-text review and 56 were included. Quetiapine extended-release showed a role in both acute and maintenance treatment of uncomplicated generalized anxiety disorder, whereas more studies are needed before drawing practical recommendations on the use of olanzapine and risperidone; aripiprazole and risperidone are effective in resistant OCD as augmentation treatments. Risperidone and olanzapine add-on may have a role in resistant or chronic post-traumatic stress disorder patients, although only risperidone addition can be recommended on the basis of the criterion of two or more positive placebo-controlled trials. This systematized review supports the evidence that only a few AAs are effective in only a minority of the off-label conditions in which they are currently used and confirms that AAs are not all the same. Their use should be on the basis of a balance between efficacy and side effects, and the characteristics as well as the preference of the patient.

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“…Thus, psychoeducation about accommodation is necessary for relatives to understand the function of a given behavior and reduce accommodation across multiple domains, beyond those covered in a brief skills-based intervention. Indeed, multiple psychoeducation-based interventions to reduce accommodation have demonstrated benefit (Albert, Maina, Saracco, & Bogetto, 2006; Thompson-Hollands et al, 2015).…”

Section: Recommendations For Cliniciansmentioning

confidence: 99%

Family accommodation in PTSD: Proposed considerations and distinctions from the established transdiagnostic literature.

Reuman

Thompson‐Hollands

2023

Clinical Psychology: Science and Practice

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Accommodation is widely documented and studied among internalizing disorders; however, the conceptualization and study of accommodation in the context of posttraumatic stress disorder (PTSD) is relatively nascent. PTSD entails many diagnostic criteria-including exposure to a distinct Criterion A event, emotional numbing, and anger-that may uniquely influence accommodation and merit special consideration. Our aim was to review the impact of accommodation in PTSD, compare and contrast accommodation in PTSD to other disorders with a strong empirical evidence base regarding accommodation, and highlight considerations unique to PTSD and associated implications for accommodation. We conclude by providing considerations for future research and practice. Public Health Significance StatementPosttraumatic stress disorder (PTSD) is a public mental health priority that exacts significant interpersonal burden; however, relatively little is known about PTSD-specific symptom accommodation by family members. Unique diagnostic criteria in PTSD highlight the need for updated empirical and clinical considerations regarding symptom accommodation. The paper provides initial support for the need for PTSD-specific approaches to clinically address accommodation and emphasizes the need for further empirical investigation of PTSD-specific accommodation.

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Multifamily Psycho educational Intervention (MPI) for obsessive-compulsive disorder: a pilot study

Cited by 7 publications

References 17 publications

Family accommodation in adult obsessive–compulsive disorder: clinical perspectives

Family accommodation in adult obsessive–compulsive disorder: clinical perspectives

Role and clinical implications of atypical antipsychotics in anxiety disorders, obsessive-compulsive disorder, trauma-related, and somatic symptom disorders

Family accommodation in PTSD: Proposed considerations and distinctions from the established transdiagnostic literature.

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Multifamily Psycho educational Intervention (MPI) for obsessive-compulsive disorder: a pilot study

Cited by 7 publications

References 17 publications

Family accommodation in adult obsessive&ndash;compulsive disorder: clinical perspectives

Family accommodation in adult obsessive&ndash;compulsive disorder: clinical perspectives

Role and clinical implications of atypical antipsychotics in anxiety disorders, obsessive-compulsive disorder, trauma-related, and somatic symptom disorders

Family accommodation in PTSD: Proposed considerations and distinctions from the established transdiagnostic literature.

Contact Info

Product

Resources

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Family accommodation in adult obsessive–compulsive disorder: clinical perspectives

Family accommodation in adult obsessive–compulsive disorder: clinical perspectives