CBT-Plus: A meta-analysis of cognitive behavioral therapy augmentation strategies for obsessive-compulsive disorder

Publication date: Available online 7 July 2018Source: Journal of Obsessive-Compulsive and Related DisordersAuthor(s): Andrew G. Guzick, Danielle L. Cooke, Nicholas Gage, Joseph P.H. McNamaraAbstractA substantial portion of people with obsessive-compulsive disorder (OCD) do not fully respond to cognitive behavioral therapy (CBT), leading clinical researchers to investigate ways to improve this treatment. The present meta-analysis evaluated 25 randomized trials that compared standard CBT with CBT plus an augmentation strategy. The combination of CBT with d-cycloserine or serotonin reuptake inhibitors was not significantly more effective than CBT alone, g = 0.043, p = .65, and g = 0.11, p = .30, respectively. Two mindfulness-based augmentations of CBT were not found to be more effective than traditional CBT, g = −.22, p = .57. Significant beneficial effects were found when CBT was integrated with specific psychosocial augmentations, including increasing family involvement in four studies, g = 0.60, p < .001, and incorporating motivational interviewing in three studies, g = 0.77, p < .001. These augmentations were most effective in studies with patients with more severe OCD, and when delivered as separate, independent therapeutic interventions. While promising, the findings for psychosocial augmentation are based on a small number of studies and should be replicated by larger trials. These results support continued investigation of novel behavioral strategies that may â...
Source: Journal of Obsessive Compulsive and Related Disorders - Category: Psychiatry Source Type: research