A qualitative study of the acceptability of an intensive format for the delivery of cognitive-behavioural therapy for obsessive-compulsive disorder

Objectives. An intensive format may be both useful and effective for the delivery of cognitive-behavioural therapy (CBT) for obsessive-compulsive disorder (OCD). However, the acceptability of an intensive treatment format from the perspective of service users is unknown. This study examines service user perspectives on the acceptability of an intensive versus a standard weekly treatment format. Design. The study comprises a detailed comparative qualitative analysis of the perspectives of service users who have completed either intensive or weekly CBT for OCD. Methods. Six treatment completers in each format (matched for age, gender, and symptom changeover the course of treatment) were asked to reflect on helpful and problematic aspects of their treatment format, and to consider the differences between treatment formats. The interviews were transcribed and analysed in detail using thematic analysis. Results. Individual differences were apparent in preference for treatment format. Weekly treatment completers were concerned that intensive treatment could be overwhelming or too brief for real change to take place. However, intensive treatment completers valued the high pressure and pace and felt that it improved motivation, engagement, and eventual outcome. Conclusion. An intensive treatment format for the delivery of CBT for OCD can be highly motivating and acceptable to service users who have chosen to undertake it. Good quality follow-up and crisis support may be particularly important following intensive treatment.