Treatment of Obsessive-Compulsive Disorder

Article excerpt

LATA K. MCGINN & WILLIAM C. SANDERSON: Treatment of Obsessive-Compulsive Disorder. Northvale, NJ, Jason Aronson Inc. 1999, 296 pp., $40.00, ISBN 0-76-570-2118.

Drs. Lata McGinn and William Sanderson have responded to the demands of the health care environment by producing an evidence-based cognitive-behavioral treatment (CBT) protocol for the Treatment of Obsessive-Compulsive Disorder Increasingly, clinicians are being required by managed care companies and other agencies to employ treatments that have empirical support. Unfortunately, few clinicians have formal training in these evidence-based treatments since limited numbers of doctoral programs in clinical psychology, psychiatry residency training programs, and psychology and social work internships employ faculty with expertise in these evidence-based treatment approaches. The age-old problem has been transporting these treatments developed in university "laboratories" to the "real world." McGinn and Sanderson achieve this goal by presenting a detailed, session-by-session guide that helps clinicians carefully assess and systematically treat obsessive-compulsive disorder (OCD).

These authors have developed a comprehensive treatment for OCD that creatively combines psychoeducation and cognitive restructuring, with traditional exposure and response prevention techniques. The techniques described in this book draw primarily from the previous work of Aaron Beck, Edna Foa, Gail Steketee, and Paul Salkovskis. McGinn and Sanderson describe a patient diagnosed with OCD and weave this clinical material throughout the book to highlight the specific techniques presented.

The first chapter of the book offers a succinct review of a cognitive-behavioral model of OCD. The authors describe the integration of the recent advances in employing cognitive restructuring with the traditional behavioral strategies. Each of the remaining eight chapters in the book is considered a "session." This structure helps clinicians organize their treatment around several content areas and stages. It is understood by the reader that this treatment is not actually completed in 8 sessions but rather each "session" is typically extended over several visits. Each session has its goals outlined at the beginning of each chapter which, when used later as a reference, helps the reader quickly review the highlights.

Session I involves the assessment of OCD which contains two primary components. First, the authors review how to establish the diagnosis and which common comorbid conditions to consider. Second, is a review of general elements of any initial assessment as well as key elements in the assessment of OCD. For example, onset and course of the disorder, prior treatments, degree of insight, are some of the general domains of any assessment, whereas anxiety triggers (internal and external), avoidance behaviors, and ritualized thoughts and behaviors, are specific assessment areas relevant to OCD. …