Obsessive-Compulsive Disorder (OCD) describes a condition in which an individual has uncontrollable thoughts and/or behaviors (i.e., compulsions) that are problematic on an ongoing basis (National Institute of Mental Health), and these symptoms can be experienced by adults as well as children and adolescents. Common treatments for OCD involve exposure therapy, which is sometimes combined with a selective-serotonin reuptake inhibitor (SSRI) medication (International OCD Foundation). However, recent advances in treatment for OCD are now including Acceptance and Commitment Therapy (ACT), which is a form of therapy that encourages individuals to accept unwanted thoughts without judgment, separate themselves from their thoughts, engage in activities that move the individual toward life values, and mindfulness (see contextualscience.org/act for more information). Although there is growing evidence for ACT as a component of treatment for OCD, the majority of these studies have been conducted with adults. Therefore, Armstrong and colleagues (2013) evaluated the effects of ACT for three adolescents (ages 12-13 years old) diagnosed with OCD.
Participants in this study reported fears about contamination and dying which were linked to problematic behaviors such as excessive hand washing, frequent reassurance-seeking, and lengthy bedtime routines. Treatment occurred weekly over the course of 8 weeks and involved a variety of components. A few examples of treatment components were 1) identifying differences between obsessions and compulsions; 2) drawing activities; 3) education about and activities surrounding the futility of fighting thoughts; 4) identifying life values; 5) accepting unwanted thoughts; and 6) mindfulness. Each treatment session was 50 min and included related homework assignments. The results of this study showed that self-reported compulsions decreased by 40%, and these effects were maintained at a 3-month follow up, and treatment was rated as highly acceptable by participants as well as their parents.
Armstong, A. B., Morrison, K. L., & Twohig, M. P. (2013). A preliminary investigation of acceptance and commitment therapy for adolescent obsessive-compulsive disorder. Journal of Cognitive Psychotherapy, 27, 175-190.
Many people witness or experience some kind of traumatic event during their lifetime; however, these events affect people in different ways. It is common for people who have witnessed or experienced a traumatic event to have some difficulty adjusting and coping, but symptoms such as flashbacks and anxiety typically improve with time (Mayo Clinic). However, for some people, symptoms get worse or persist for several months or years and interfere with daily functioning, which is usually an indication of Post-Traumatic Stress Disorder (PTSD; Mayo Clinic). A common form of treatment for PTSD is exposure-based therapy which involves intentionally imagining the traumatic experience and interacting with people, places, or things that are associated with or related to the traumatic event (Gros et al., 2012). However, some individuals with PTSD also have symptoms of depression which sometimes persist after treatment for PTSD (Gros et al., 2012). Due to this concern, Gros and colleagues (2012) sought to evaluate the effects of a treatment package for individuals with PTSD and depression which included evidence-based therapies for each of these conditions.
Eighty-two combat veterans completed participation in the current study which incorporated exposure therapy and behavioral activation (BA)—an evidence-based treatment for depression involving planning activities that are aligned with personal values. Each treatment session was 90 minutes, and participants completed eight treatment sessions. Treatment consisted of encouraging participants to plan activities consistent with personal values—some of which involved exposure to feared situations such as shopping in a crowded mall—and writing or speaking about the traumatic event (i.e., imaginal exposure). In this way, participants used behavioral activation combined with exposure therapy. Throughout the study, participants completed a variety of questionnaires designed to assess the severity of symptoms of PTSD and depression. Overall, researchers observed improvements in PTSD and overlapping symptoms of PTSD and depression; however, similar effects were not observed for nonoverlapping symptoms of depression. The authors concluded that more research is needed to determine the effects of specific treatment components on specific symptoms of PTSD and depression, and which additional treatment components may enhance treatment effects.