Enhancing exposure and response prevention for OCD: a couple-based approach.
Adding the partner to ERP looks doable and may keep adults in treatment longer.
01Research in Context
What this study did
Three couples tried a new twist on ERP. The partner joined every session.
The therapist taught both people about OCD. The partner learned how to stop helping the rituals.
They practiced exposures together at home. No numbers were tracked.
What they found
All three couples finished the program. They said it felt doable.
The stories show the partner could coach exposure and still be supportive.
How this fits with other research
Vos et al. (2013) got big drops in compulsions with eight ACT sessions and no partner. S et al. added the partner but gave no numbers. The two ideas can live side-by-side: try ACT first, then pull in the spouse if gains stall.
Moritz et al. (2009) found facts alone do not calm OCD minds. S et al. agree; their program spends little time lecturing and lots of time doing exposure together.
Smith et al. (2010) showed many adults with OCD also have autism or ADHD traits. A partner who knows these patterns can slow the pace and use clearer prompts during exposure.
Why it matters
If a client keeps quitting ERP, invite the partner. Teach them to spot subtle accommodation, like handing over paper towels for excessive hand washing. One simple rule: praise brave exposure, stay quiet during rituals. Try it next session.
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02At a glance
03Original abstract
The effectiveness of individual therapy by exposure and response prevention (ERP) for obsessive-compulsive disorder (OCD) is well established, yet not all patients respond well, and some show relapse on discontinuation. This article begins by providing an overview of the personal and interpersonal experiences of OCD, focusing on interpersonal processes that maintain OCD symptoms and interfere with ERP. The study then describes a couple-based treatment program that the authors have developed to enhance ERP for individuals with OCD who are in long-term relationships. This program involves psychoeducation, partner-assisted exposure therapy, couple-based interventions aimed at changing maladaptive relationship patterns regarding OCD (i.e., symptom accommodation), and general couple therapy. Three case examples are presented to illustrate the couple-based techniques used in this treatment program.
Behavior modification, 2013 · doi:10.1177/0145445512444596