Using Motivational Interviewing to Enhance Treatment Outcome in Obsessive-Compulsive Disorder

Plans to study a two-pronged behavioral approach to help people who have obsessive compulsive disorder (OCD). Cognitive-behavioral therapy (CBT) consisting of exposure and ritual prevention (EX/RP) is one of the best OCD treatments, but EX/RP's effectiveness is limited by patient attrition and/or partial adherence to the EX/RP procedures. Motivational Interviewing (MI) is a structured therapeutic method for enhancing motivation to change by exploring and resolving ambivalence. MI interventions have been used successfully in alcohol abuse and several other disorders to increase treatment entry, retention, and adherence and to enhance treatment outcome. But MI has not been systematically adapted for people with severe mental illness. The goal of this study is to develop and pilot test an EX/RP+MI intervention for OCD that improves EX/RP outcome by enhancing EX/RP retention and adherence. If successful, this model (using MI to enhance treatment participation) could be adapted for children and extended to medication treatment for OCD. The same model may also be applicable to other severe mental illnesses (e.g., major depression, bipolar disorder, schizophrenia) that have efficacious treatments but substantial problems with treatment adherence.