Establishment of behavioural self-help groups for obsessive compulsive disorder by expert training: An experimental study

Obsessive compulsive disorder (OCD) often tends to develop a chronic course of illness. Treatment results with multimodal behaviour therapy are less impressive than in most anxiety disorders. The same holds true for pharmacotherapy, as positive effects usually disappear in more than 70% of patients soon after drug withdrawal. In contrast to many other psychiatric and somatic disorders with a chronic course, there are hardly any long-term Self-Help groups for patients with OCD. Apart from OCD symptomatology, it appears that early chronic social deficits and pseudo-coping (by latent aggressiveness), both leading to severe communication disturbances, are the main reasons for this situation. It is possible to foster the establishment of useful self-help groups for OCD by initial short-term training with expert behaviour therapists? This study investigates the results with 45 patients, distributed over 8 groups (5-8 members each). Most patients had a very chronic course of illness and had received multimodal previous treatments (behaviour therapy, psychotherapy, pharmacotherapy). The chances and limits of a systematic expert training over the first 10 sessions (once a week) and the subsequent development of the groups without therapists are demonstrated. Main aims of this training were: 'Unspecific' (improvement of communication skills and 'group suitability'; coping with daily life problems; increased pleasure and gratification from daily life activities) and symptom-'specific' (information about OCD and its treatment; training in functional self-analysis of biographical and current events and obsessive compulsive behaviours; behavioural self-help for obsessions and compulsions, such as exposure). Outcome data were analysed considering specifically the degree of illness, chronicity, the amount and quality of previous treatments and parallel medication. Recommendations for future research are given.