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EXPOSURE THERAPY EXPLAINED
A Treatment For This Condition Already Exists
Its Effect On Symptoms Has Been Measured In Children And Adults
Treatments Can Exist Without Being Delivered
One Survey Counted How Many Severe Cases Are Treated For It
Years Pass Between The Symptoms Starting And Treatment Beginning
Waiting Longer Predicts A Worse Result Later
This Part Covers What Works And Who Actually Gets It
THIS NEWSLETTER IS FOR INFORMATIONAL PURPOSES ONLY. NOTHING IN THIS CONTENT CONSTITUTES MEDICAL, PSYCHOLOGICAL, OR PROFESSIONAL ADVICE. ALWAYS CONSULT A QUALIFIED HEALTHCARE PROFESSIONAL BEFORE MAKING ANY HEALTH RELATED DECISIONS.
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OKAY BACK FROM THE WAITING ROOM 🪑
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THE TREATMENT WITH THE BEST EVIDENCE 🧗
Exposure And Response Prevention Is The Treatment Of Choice
Researchers Shorten That Name To ERP
It Works Through Gradual And Prolonged Exposure
The Exposure Is To Fear Provoking Stimuli
Instructions To Abstain From The Compulsive Behaviour Run Alongside
Abstaining Is What Separates ERP From Exposure On Its Own
Cognitive Components Are Often Integrated With That Exposure
Discussing Feared Consequences Can Make ERP Less Aversive
Meta Analyses Of Randomised Controlled Trials Have Tested This
They Consistently Show That CBT Significantly Improves OCD Symptoms
Adults And Children Both Appear In That Finding
One Review Reported A Number Needed To Treat Of 3 For CBT
The Same Review Reported 5 For SSRIs
A Lower Number Means Fewer People Treated Per Person Helped
SSRIs Are The First Line Pharmacological Treatment For OCD
Both Approaches Have Randomised Evidence Supporting Them
Neither Approach Helps Everybody It Treats
Around Half Given A First Line Treatment Fail To Fully Respond
Failing To Fully Respond Is Not The Same As Failing Entirely
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WHAT THE NUMBERS SAY ABOUT REACH 📉
Effectiveness In A Trial Is Not The Same As Availability
The National Comorbidity Survey Replication Looked At That Gap
Researchers Abbreviate It To The NCS R
The Sample Was Adults Across The United States
It Examined People Whose OCD Was Severe
Only A Minority Of Those Severe Cases Received OCD Specific Treatment
The Reported Figure Was 30.9%
Treatment Obtained For Other Problems Was Counted Separately
That Percentage Describes Severe Cases Rather Than Everyone Diagnosed
Access To Evidence Based Care Varies Around The World
Variation Is Particularly Marked For CBT
A Trial Result Assumes A Trained Therapist Nearby
Availability Is Not Evenly Distributed
Substantial Delays Can Occur Before Patients Seek Treatment
Lack Of Knowledge About The Disorder Is One Named Reason
Embarrassment About The Symptoms Is A Second
Anxiety About Exposure To Feared Stimuli Is The Last One
That Last Reason Deserves A Closer Look
ERP Requires Facing Exactly Those Stimuli
The Barrier Names Exactly What The Treatment Requires
Each Of Those Reasons Costs Time Before Treatment Starts
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THE YEARS BEFORE ANYONE STARTS ⏱️
Researchers Measure That Delay As Duration Of Untreated Illness
The Short Form Is DUI
A Systematic Review Gathered The Studies That Reported It
Only Eight Papers Met Its Criteria
The DUI Ranged From 7.0 Years To 20.9 Years Across Them
Standard Deviations Of 8.5 And 11.2 Years Accompanied Those Figures
Deviations That Wide Cover Very Different Individual Experiences
The Same Review Cites An Average Elsewhere In The Literature
That Average Runs From 87.5 Up To 94.5 Months
Converting Those Months Gives Roughly Seven To Eight Years
Eight Papers Is A Small Evidence Base For A Question This Large
The Review Calls The Topic Overlooked
Its Central Finding Concerns The Effect Of That Delay
Patients Reporting A Longer DUI Have A Poor Long Term Outcome
Lower Level Of Treatment Response Is One Half Of That
Greater Symptom Severity Is The Other Half
The Review Recommends Promoting Early Interventions
Those Interventions Should Focus Specifically On OCD Symptoms
What The Studies Show Is An Association Rather Than A Cause
A Delay Is Still Not A Neutral Pause In This Condition
