ERP to Improve Functioning in Veterans With OCD
Obsessive Compulsive Disorder (OCD), Comorbid Post-Traumatic Stress Disorder and OCD
About this trial
This is an interventional treatment trial for Obsessive Compulsive Disorder (OCD) focused on measuring Obsessive Compulsive Disorder, OCD, Post-Traumatic Stress Disorder, PTSD, Worry, Compulsion, Stress
Eligibility Criteria
Inclusion Criteria:
- Veterans having a primary diagnosis of Obsessive Compulsive Disorder (OCD)(50% of sample) and comorbid OCD and Post-traumatic stress disorder (PTSD) (50% of sample) who are receiving care from the Michael E. DeBakey VA Medical Center (MEDVAMC) in Houston, TX; the Ralph H. Johnson VA Medical Center in Charleston, SC; and the VISN 20 Clinical Resource Hub which provides telehealth services to Washington, Oregon, and Alaska.
- Willingness to participate in Exposure and Response Prevention(ERP)
Exclusion Criteria:
- Significant cognitive impairment or conditions that threaten safety (current psychosis, mania, imminent suicidality including plan or intent, and treatment-interfering moderate to severe substance use).
- Potential participants taking psychotropic medications must be on a stable dose of these medications for at least 6 weeks prior to study enrollment.
Sites / Locations
- VA Roseburg Healthcare System, Roseburg, ORRecruiting
- VA Southern Oregon Rehabilitation Center and Clinics, White City, ORRecruiting
- Ralph H. Johnson VA Medical Center, Charleston, SCRecruiting
- Michael E. DeBakey VA Medical Center, Houston, TXRecruiting
- Spokane VA Medical Center, Spokane, WARecruiting
- Jonathan M. Wainwright Memorial VA Medical Center, Walla Walla, WARecruiting
Arms of the Study
Arm 1
Arm 2
Experimental
Other
Exposure and Response Prevention (ERP)
Control Condition
ERP will be based upon the Treatments That Work series, which contains both a provider manual and client workbook. Sessions will last 90 minutes and occur weekly for 16 sessions. All ERP treatment will be delivered via VTH. Participants will receive instructions on accessing the VTH platform and take part in a brief practice run connecting to the VTH appointment with guidance from an RA. ERP treatment content includes psychoeducation about OCD, assessment of OCD symptoms, the rationale for treatment, construction of a hierarchy or a list of feared or avoided situations, and in-session in-vivo and imaginal exposures. Weekly homework assignments will include self-monitoring, reading chapters about the treatment, and practicing exposures daily. All therapy sessions will be audio-recorded. Although sessions are expected to occur weekly, accounting for delays due to scheduling, holidays, and missed appointments, the investigators will allow up to 6 months to complete the treatment.
Participants randomized to the control condition will receive 16 weekly sessions of stress management training via video telehealth. This control condition was chosen because it is expected to provide the therapeutic alliance and common factors associated with therapy generally and some specific effects in anxiety reduction.