A randomized clinical trial of acceptance and commitment therapy versus progressive relaxation training for obsessive-compulsive disorder

摘要

Objective: Effective treatments for obsessive-compulsive disorder (OCD) exist, but additional treatment options are needed. The effectiveness of 8 sessions of acceptance and commitment therapy (ACT) for adult OCD was compared with progressive relaxation training (PRT). Method: Seventy-nine adults (61 female) diagnosed with OCD (mean age = 37 years; 89 Caucasian) participated in a randomized clinical trial of 8 sessions of ACT or PRT with no in-session exposure. The following assessments were completed at pretreatment, posttreatment, and 3-month follow-up by an assessor who was unaware of treatment conditions: Yale-Brown Obsessive Compulsive Scale (Y-BOCS), Beck Depression Inventory-II, Quality of Life Scale, Acceptance and Action Questionnaire, Thought Action Fusion Scale, and Thought Control Questionnaire. Treatment Evaluation Inventory was completed at posttreatment. Results: ACT produced greater changes at posttreatment and follow-up over PRT on OCD severity (Y-BOCS: ACT pretreatment = 24.22, posttreatment = 12.76, follow-up = 11.79; PRT pretreatment = 25.4, posttreatment = 18.67, follow-up = 16.23) and produced greater change on depression among those reporting at least mild depression before treatment. Clinically significant change in OCD severity occurred more in the ACT condition than PRT (clinical response rates: ACT posttreatment = 46-56, follow-up = 46-66; PRT posttreatment = 13-18, follow-up = 16-18). Quality of life improved in both conditions but was marginally in favor of ACT at posttreatment. Treatment refusal (2.4 ACT, 7.8 PRT) and dropout (9.8 ACT, 13.2 PRT) were low in both conditions. Conclusions: ACT is worth exploring as a treatment for OCD.