Behavioral group therapy for obsessive-compulsive disorder in Norway: An effectiveness study and the relationship of metacognitions and early maladaptive schemas to treatment outcome

Abstract

The primary aim of Paper I was to test the effectiveness of behavioral group therapy in a Norwegian community mental health setting. The results showed that behavioral group therapy with obsessive-compulsive disorder (OCD) patients with a large amount of comorbidity, produced large effect sizes, low dropout rates and a large proportion of recovered patients. Moreover, patients showed further significant improvement between post-treatment to the 3-month follow-up. Paper I suggests that behavioral group therapy is generalizable to ordinary clinical practice.

In Paper II, cognitive and metacognitive changes were evaluated in patients undergoing exposure and response prevention (ERP) for OCD. The goal was to determine which of these changes best correlated with reductions in obsessivecompulsive symptoms. The main finding from this study was that a change in metacognitions explained a large proportion of the variance in obsessiv-compulsive symptoms. Metacognitions were more related to treatment outcome than cognitions such as perfectionism/certainty and responsibility/harm.

The primary aim of Paper III was to examine the role of early maladaptive schema (EMS) in the outcome of standard ERP for OCD. It was questioned whether pretreatment EMS would predict changes in obsessive-compulsive symptoms after treatment and whether changes in EMS were significantly related to outcome. The main findings demonstrated that higher pre-treatment scores on the abandonment schema predicted poorer outcomes and that higher pre-treatment score on the selfsacrifice schema predicted better outcomes. Furthermore, the results showed that decreases in the failure schema during treatment were related to good outcomes.