None listed
Conditions
Brief summary
The perinatal period has been identified as a period of increased risk for obsessive compulsive disorder (OCD) onset and worsening, for both mothers and fathers. Preliminary research suggests that metacognitive therapy (MCT) may be an effective treatment for OCD. MCT focuses on correcting misinterpretations about the meaning and importance of intrusive thoughts, and the need to control these. MCT does not involve the use of traditional exposure and response prevention exercises for OCD, often experienced as aversive by participants. Small trials to date have noted low drop out rates for MCT, so it proposed to be well tolerated by participants. Preliminary research also indicates that MCT may be an effective transdiagnostic treatment approach, meaning that it may be able to treat multiple psychological problems by targeting shared underlying maintaining factors. In clinically diverse populations, significant improvements were noted in depression, anxiety, worry, rumination and metacognition following a MCT intervention, with treatment gains sustained over 6 month follow-up. In populations with a primary OCD diagnosis MCT was found to be effective with a range of comorbid mental health conditions reflecting transdiagnostic efficacy of the treatment. To date, no studies have evaluated the use of MCT for OCD that has onset or worsened in the perinatal period. The aim of the present study is to investigate the efficacy of an 8-week group MCT program for perinatal OCD. It is hypothesised that: 1. Participants will show a categorical improvement in OCD symptoms following MCT, demonstrated by no longer meeting the diagnostic criteria for OCD at post-treatment, and maintained at 3-month follow-up. 2. Participants will show a reduction in symptom severity and intensity of OCD following MCT, demonstrated by meeting clinically significant and reliable change criteria, at post-treatment and maintained at follow-up. 3. Participants will show a reduction in co-morbid depressive symptoms following MCT, demonstrated by decreased scores on measures of depressive symptoms. 4. Participants will show decreases in scores of unhelpful metacognitive and cognitive beliefs following MCT
Interventions
The program will follow the manualised metacognitive therapy procedure outlined in Rees, “OCD: A practical guide to treatment (2009)”. Eight group treatment sessions of two hours duration each will be held once per week over eight weeks. Sessions 1-2 will cover engagement (psychoeducation and normalisation, increasing motivation to change, goal setting, treatment rationale, and shifting to the metacognitive mode). Sessions 3-7 will focus on metacognitive therapy (awareness and modification of a
The program will follow the manualised metacognitive therapy procedure outlined in Rees, “OCD: A practical guide to treatment (2009)”. Eight group treatment sessions of two hours duration each will be held once per week over eight weeks. Sessions 1-2 will cover engagement (psychoeducation and normalisation, increasing motivation to change, goal setting, treatment rationale, and shifting to the metacognitive mode). Sessions 3-7 will focus on metacognitive therapy (awareness and modification of attentional strategies and maladaptive metacognitive beliefs, including behavioural experiments). Session 8 will detail relapse prevention planning. The intervention will be delivered by psychologists undertaking postgraduate training in clinical psychology, under the supervision of a Registered Clinical Psychologist. Supervision will be provided on a weekly basis to ensure adherence to the treatment protocol. The intervention will be delivered at the Curtin University Psychology Clinic.
Sponsors
Curtin University
Study design
Allocation
Non-randomised trial
Intervention model
Single group
Primary purpose
Treatment
Masking
Open (masking not used)
Eligibility
Sex/Gender
All
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
Individuals with a primary OCD diagnoses with onset or worsening of symptoms, and a significant impact on functioning, within 6 months of having a baby will be included in the study. Every participant included in the intervention must have a referring clinician who is a registered health professional. Males and females. Over 18 years of age.
Exclusion criteria
Any individuals with psychotic symptoms, drug and alcohol dependency, severe intellectual disabilities, child protection issues, current high-risk for self-harm/suicidality, or engaging in concurrent psychological treatment will be excluded from the study. Participants will be asked to maintain their current medication dose unless otherwise indicated by their managing medical professional.
Outcome results
None listed