Efficacy of guided imagery technique combined with exposure and response prevention for obsessive-compulsive disorder
Year: 2024
Type: article
Abstract: Sir, Obsessive-compulsive disorder (OCD) is a distressing and debilitating condition affecting 1–2% of the population. Exposure and response prevention (ERP) has the strongest evidence for effectiveness in OCD treatment.[1] Results of a meta-analysis indicated the superiority of ERP as compared to the other psychological treatment methods in patients with OCD.[2] Guided imagery is a type of relaxation technique that uses visualization to calm the client. It is also used in the reduction of anxiety, depression, and pain.[3] This technique is based on mind-body interaction which can be applied either by self, by professional, or by a tape recording. The technique ceases the activity of the sympathetic nervous system which makes us attentive, vigorous, and stressed to fight in a frightening situation. It changes physiological responses to stress and helps in the improvement of the immune system.[4] A 28-year-old man, educated up to graduation, single, Hindu, Hindi-speaking, businessman, of middle socioeconomic status, and resides in an urban area on treatment for OCD with psychotropic medications was referred for psychotherapy. Patients came to the outpatient department (OPD) alone, presenting with complaints of unwanted and intrusive thoughts, repetitive doubts, checking and counting behaviors, irritability, feelings of sadness, lack of interest in daily activities or joyful activities, avoiding work related to his obsession, hopelessness, disturbed sleep, and appetite from last 5 years. While working as a cashier in his family business, he started feeling anxious while counting money due to intrusive thoughts and doubts in counting. In response to doubts, he began to repeat counting many times. Gradually, he doubts every work as he has not done it correctly so he has to repeat those many times until he feels satisfied. He knows very well that these thoughts are irrational even though he cannot stop and repeats the work until satisfied. However, in the repetition of every work, he spent 1–2 hours which was the reason for his frustration and irritability. When his father goes out of the station, he has all responsibility for trade work at that time his anxiety increases a lot. He tries to avoid doing that work. He started feeling sad and showed a lack of interest in daily activities or joyful activities, hopelessness, disturbed sleep, and appetite. He was assessed with the Yale-Brown Obsessive Compulsive Scale (YBOCS), Beck Depression Inventory (BDI), Hopelessness Scale of Beck et al. (HSB), and world health organization quality of life (WHOQOL-BREF) at baseline, post-intervention, and after a follow-up of 1 month. The patient’s symptoms decreased after 12 weekly therapeutic sessions and were maintained at follow-up [Table 1]. The patient’s YBOCS scores, BDI scores, and HSB showed improvement from OC and depressive symptoms. Post-intervention and follow-up scores on WHOQOL-BRIEF suggested improved quality of life in the patient. Previous studies indicate that patients with OCD have a poor quality of life as compared to healthy controls.[5] So, the integration of guided imagery with the ERP technique with the psychiatric treatment facilitates the extinction of hidden anxiety and depression in the patient and faster recovery from OCD symptoms. They also facilitate the prevention of irresistible thoughts, and compulsive acts, and increase the quality of life.Table l: Pre-, post, and follow-up assessment scores of the patient on the Yale-Brown Obsessive Compulsive Scale, Beck Depression Inventory, Hopelessness Scale of Beck et al.,[ 5 ] and WHOQOL-BREFDeclaration of patient consent The authors certify that they have obtained all appropriate patient consent forms. In the form, the patient has given his consent for his images and other clinical information to be reported in the journal. The patient understands that his name and initials will not be published and due efforts will be made to conceal identity, but anonymity cannot be guaranteed. Author’s contribution Concept, design, definition of intellectual content, literature search, data acquisition: DK, NM Manuscript preparation: DK, NM Manuscript editing and manuscript review. DK, Guarantor: DK. Financial support and sponsorship Nil. Conflicts of interest There are no conflicts of interest.
Source: Industrial Psychiatry Journal
Authors: Dolly Kumari, Nikhil Mohan
Language: English
Subfield: Clinical Psychology
Field: Psychology
Domain: Social Sciences
Open Access status: gold
Estimated APC paid: $60
OpenAlex ID: W4404389642