Patients' experiences of cognitive behavioural therapy and eye movement desensitisation and reprocessing as treatments for obsessive-compulsive disorder

Introduction

Obsessive-compulsive disorder (OCD) is usually treated with cognitive behavioural therapy (CBT) based on exposure and response prevention principles; although eye movement desensitisation and reprocessing (EMDR) has also been proposed as a potentially helpful treatment.

Aim

To investigate patients’ experiences of the process and outcome of CBT and EMDR.

Method

We conducted in-depth qualitative interviews with 24 (EMDR = 14; CBT = 10) patients who participated in a randomised controlled trial. Interviews were conducted after the end of therapy, transcribed verbatim and interpreted using thematic analysis.

Results

Three superordinate themes were identified, including (1) common experiences and specific experiences of (2) CBT and (3) EMDR. Common experiences of therapy included difficulties in disclosing OCD problems; perceptions about therapists as approachable and nonjudgemental; sudden symptomatic improvements; difficulties in engaging with treatment; general satisfaction with therapy; and viewing OCD as a long-term condition. Some differences between these interventions were also found in patients’ understanding of the treatment rationale, their experiences and difficulties with specific treatment procedures.

Conclusions

Common process factors were especially prominent in patients’ accounts, although it is possible that these interact with more specific change mechanisms such as desensitisation.