FURTHER EVIDENCE FOR THE EFFICACY OF ASSOCIATION SPLITTING AS A SELF-HELP TECHNIQUE FOR REDUCING OBSESSIVE THOUGHTS


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Abstract

Background:Despite improved treatment options, many people with obsessive–compulsive disorder (OCD) do not seek or even actively avoid therapy due to shame or fear of stigmatization. Self-help treatment is increasingly acknowledged as a means to “treat the untreated” and to motivate patients for face-to-face psychotherapy. Our group has gathered preliminary evidence for the efficacy of a novel self-help approach entitled association splitting (AS) aimed at the reduction of obsessions.Methods:For this study, a total of 46 participants with a likely diagnosis of OCD were randomly allocated to either AS or a waitlist control (WL). Treatment consisted of the self-study of a manual sent via e-mail. At baseline and four weeks later symptoms were assessed online using the self-report version of the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS), the Obsessive-Compulsive Inventory-Revised (OCI-R), and the Beck Depression Inventory (BDI).Results:A total of 74% of the initial sample took part in the re-assessment. Results were in accordance with prior uncontrolled data indicating that AS is a feasible approach leading to a symptom decline of approximately 25% on the Y-BOCS. The technique also exerted a positive effect on depression (BDI) and the OCI-R subscale obsessive thoughts.Conclusions:The study confirms the feasibility and efficacy of AS for a subgroup of patients with OCD. Ongoing studies explore whether short-term effects are maintained over time and whether therapist-guided therapy may enhance the efficacy of AS. Depression and Anxiety, 2011. © 2011 Wiley-Liss, Inc.

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