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Published in: BMC Psychiatry 1/2012

Open Access 01-12-2012 | Research article

Mindfulness-based cognitive therapy in obsessive-compulsive disorder – A qualitative study on patients’ experiences

Authors: Elisabeth Hertenstein, Nina Rose, Ulrich Voderholzer, Thomas Heidenreich, Christoph Nissen, Nicola Thiel, Nirmal Herbst, Anne Katrin Külz

Published in: BMC Psychiatry | Issue 1/2012

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Abstract

Background

Cognitive behavioral therapy (CBT) with exposure and response prevention (ERP) is the first-line treatment for patients with obsessive-compulsive disorder (OCD). However, not all of them achieve remission on a longterm basis. Mindfulness-based cognitive therapy (MBCT) represents a new 8-week group therapy program whose effectiveness has been demonstrated in various mental disorders, but has not yet been applied to patients with OCD.
The present pilot study aimed to qualitatively assess the subjective experiences of patients with OCD who participated in MBCT.

Method

Semi-structured interviews were conducted with 12 patients suffering from OCD directly after 8 sessions of a weekly MBCT group program. Data were analyzed using a qualitative content analysis.

Results

Participants valued the treatment as helpful in dealing with their OCD and OCD-related problems. Two thirds of the patients reported a decline in OCD symptoms. Benefits included an increased ability to let unpleasant emotions surface and to live more consciously in the present. However, participants also discussed several problems.

Conclusion

The data provide preliminary evidence that patients with OCD find aspects of the current MBCT protocol acceptable and beneficial. The authors suggest to further explore MBCT as a complementary treatment strategy for OCD.
Literature
1.
go back to reference Kabat-Zinn J: Full catastrophe living: Using the wisdom of your body and mind to face stress, pain, and illness. 2005, New York, NY US: Delta Trade Paperback/Bantam Dell, 15 anniversary ed Kabat-Zinn J: Full catastrophe living: Using the wisdom of your body and mind to face stress, pain, and illness. 2005, New York, NY US: Delta Trade Paperback/Bantam Dell, 15 anniversary ed
2.
go back to reference Segal ZV, Williams JMG, Teasdale JD: Mindfulness-based cognitive therapy for depression: A new approach to preventing relapse. 2002, New York, NY US: Guilford Press Segal ZV, Williams JMG, Teasdale JD: Mindfulness-based cognitive therapy for depression: A new approach to preventing relapse. 2002, New York, NY US: Guilford Press
3.
go back to reference Chiesa A, Serretti A: Mindfulness based cognitive therapy for psychiatric disorders: A systematic review and meta-analysis. Psychiatry Res. 2011, 187: 441-453. 10.1016/j.psychres.2010.08.011.CrossRefPubMed Chiesa A, Serretti A: Mindfulness based cognitive therapy for psychiatric disorders: A systematic review and meta-analysis. Psychiatry Res. 2011, 187: 441-453. 10.1016/j.psychres.2010.08.011.CrossRefPubMed
4.
go back to reference Fjorback LO, Arendt M, Ørnbøl E, Fink P, Walach H: Mindfulness‐Based Stress Reduction and Mindfulness‐Based Cognitive Therapy—A systematic review of randomized controlled trials. Acta Psychiatr Scand. 2011, 124: 102-119. 10.1111/j.1600-0447.2011.01704.x.CrossRefPubMed Fjorback LO, Arendt M, Ørnbøl E, Fink P, Walach H: Mindfulness‐Based Stress Reduction and Mindfulness‐Based Cognitive Therapy—A systematic review of randomized controlled trials. Acta Psychiatr Scand. 2011, 124: 102-119. 10.1111/j.1600-0447.2011.01704.x.CrossRefPubMed
5.
go back to reference Allen M, Bromley A, Kuyken W, Sonnenberg SJ: Participants’ experiences of mindfulness-based cognitive therapy: “It changed me in just about every way possible. Behav Cognit Psychother. 2009, 37: 413-430. 10.1017/S135246580999004X.CrossRef Allen M, Bromley A, Kuyken W, Sonnenberg SJ: Participants’ experiences of mindfulness-based cognitive therapy: “It changed me in just about every way possible. Behav Cognit Psychother. 2009, 37: 413-430. 10.1017/S135246580999004X.CrossRef
6.
go back to reference Finucane A, Mercer SW: An exploratory mixed methods study of the acceptability and effectiveness of mindfulness-based cognitive therapy for patients with active depression and anxiety in primary care. BMC Psychiatry. 2006, 6: 14-10.1186/1471-244X-6-14.CrossRefPubMedPubMedCentral Finucane A, Mercer SW: An exploratory mixed methods study of the acceptability and effectiveness of mindfulness-based cognitive therapy for patients with active depression and anxiety in primary care. BMC Psychiatry. 2006, 6: 14-10.1186/1471-244X-6-14.CrossRefPubMedPubMedCentral
7.
go back to reference Bailie C, Kuyken W, Sonnenberg S: The experiences of parents in mindfulness-based cognitive therapy. Clin Child Psychol Psychiatry. 2012, 17: 103-119. 10.1177/1359104510392296.CrossRefPubMed Bailie C, Kuyken W, Sonnenberg S: The experiences of parents in mindfulness-based cognitive therapy. Clin Child Psychol Psychiatry. 2012, 17: 103-119. 10.1177/1359104510392296.CrossRefPubMed
8.
go back to reference Chadwick P, Kaur H, Swelam M, Ross S, Ellett L: Experience of mindfulness in people with bipolar disorder: A qualitative study. Psychother Res. 2011, 21: 277-285. 10.1080/10503307.2011.565487.CrossRefPubMed Chadwick P, Kaur H, Swelam M, Ross S, Ellett L: Experience of mindfulness in people with bipolar disorder: A qualitative study. Psychother Res. 2011, 21: 277-285. 10.1080/10503307.2011.565487.CrossRefPubMed
9.
go back to reference Williams MJ, McManus F, Muse K, Williams JMG: Mindfulness‐based cognitive therapy for severe health anxiety (hypochondriasis): An interpretative phenomenological analysis of patients’ experiences. Br J Clin Psychol. 2011, 50: 379-397. 10.1111/j.2044-8260.2010.02000.x.CrossRefPubMed Williams MJ, McManus F, Muse K, Williams JMG: Mindfulness‐based cognitive therapy for severe health anxiety (hypochondriasis): An interpretative phenomenological analysis of patients’ experiences. Br J Clin Psychol. 2011, 50: 379-397. 10.1111/j.2044-8260.2010.02000.x.CrossRefPubMed
10.
go back to reference Ruscio AM, Stein DJ, Chiu WT, Kessler RC: The epidemiology of obsessive-compulsive disorder in the National Comorbidity Survey Replication. Mol Psychiatry. 2010, 15: 53-63. 10.1038/mp.2008.94.CrossRefPubMed Ruscio AM, Stein DJ, Chiu WT, Kessler RC: The epidemiology of obsessive-compulsive disorder in the National Comorbidity Survey Replication. Mol Psychiatry. 2010, 15: 53-63. 10.1038/mp.2008.94.CrossRefPubMed
11.
go back to reference Rosa-Alcázar AI, Sánchez-Meca J, Gómez-Conesa A, Marín-Martínez F: Psychological treatment of obsessive-compulsive disorder: A meta-analysis. Clin Psychol Rev. 2008, 28: 1310-1325. 10.1016/j.cpr.2008.07.001.CrossRefPubMed Rosa-Alcázar AI, Sánchez-Meca J, Gómez-Conesa A, Marín-Martínez F: Psychological treatment of obsessive-compulsive disorder: A meta-analysis. Clin Psychol Rev. 2008, 28: 1310-1325. 10.1016/j.cpr.2008.07.001.CrossRefPubMed
12.
go back to reference Eddy KT, Dutra L, Bradley R, Westen D: A multidimensional meta-analysis of psychotherapy and pharmacotherapy for obsessive-compulsive disorder. Clin Psychol Rev. 2004, 24: 1011-1030. 10.1016/j.cpr.2004.08.004.CrossRefPubMed Eddy KT, Dutra L, Bradley R, Westen D: A multidimensional meta-analysis of psychotherapy and pharmacotherapy for obsessive-compulsive disorder. Clin Psychol Rev. 2004, 24: 1011-1030. 10.1016/j.cpr.2004.08.004.CrossRefPubMed
13.
go back to reference Hohagen F, Winkelmann G, Rasche-Räuchle H, Hand I, König A, Münchau N, Hiss H, Geiger-Kabisch C, Käppler C, Schramm P, Rey E, Aldenhoff J, Berger M: Combination of behaviour therapy with fluvoxamine in comparison with behaviour therapy and placebo: Results of a multicentre study. Br J Psychiatry. 1998, 173: 71-78. Hohagen F, Winkelmann G, Rasche-Räuchle H, Hand I, König A, Münchau N, Hiss H, Geiger-Kabisch C, Käppler C, Schramm P, Rey E, Aldenhoff J, Berger M: Combination of behaviour therapy with fluvoxamine in comparison with behaviour therapy and placebo: Results of a multicentre study. Br J Psychiatry. 1998, 173: 71-78.
14.
go back to reference Simpson HB, Huppert JD, Petkova E, Foa EB, Liebowitz MR: Response Versus Remission in Obsessive-Compulsive Disorder. J Clin Psychiatry. 2006, 67: 269-276. 10.4088/JCP.v67n0214.CrossRefPubMed Simpson HB, Huppert JD, Petkova E, Foa EB, Liebowitz MR: Response Versus Remission in Obsessive-Compulsive Disorder. J Clin Psychiatry. 2006, 67: 269-276. 10.4088/JCP.v67n0214.CrossRefPubMed
15.
go back to reference Chosak A, Marques L, Fama J, Renaud S, Wilhelm S: Cognitive therapy for obsessive-compulsive disorder: A case example. Cogn Behav Pract. 2009, 16: 7-17. 10.1016/j.cbpra.2008.01.005.CrossRef Chosak A, Marques L, Fama J, Renaud S, Wilhelm S: Cognitive therapy for obsessive-compulsive disorder: A case example. Cogn Behav Pract. 2009, 16: 7-17. 10.1016/j.cbpra.2008.01.005.CrossRef
16.
go back to reference Didonna F: Mindfulness and obsessive-compulsive disorder: Developing a way to trust and validate one’s internal experience. Clinical handbook of mindfulness. Edited by: Didonna F. 2009, New York, NY US: Springer Science + Business Media, 189-219.CrossRef Didonna F: Mindfulness and obsessive-compulsive disorder: Developing a way to trust and validate one’s internal experience. Clinical handbook of mindfulness. Edited by: Didonna F. 2009, New York, NY US: Springer Science + Business Media, 189-219.CrossRef
17.
go back to reference Fairfax H: The use of mindfulness in obsessive compulsive disorder: Suggestions for its application and integration in existing treatment. Clin Psychol Psychot. 2008, 15: 53-59. 10.1002/cpp.557.CrossRef Fairfax H: The use of mindfulness in obsessive compulsive disorder: Suggestions for its application and integration in existing treatment. Clin Psychol Psychot. 2008, 15: 53-59. 10.1002/cpp.557.CrossRef
18.
go back to reference Hanstede M, Gidron Y, Nyklíček I: The effects of a mindfulness intervention on obsessive-compulsive symptoms in a non-clinical student population. J Nerv Ment Dis. 2008, 196: 776-779. 10.1097/NMD.0b013e31818786b8.CrossRefPubMed Hanstede M, Gidron Y, Nyklíček I: The effects of a mindfulness intervention on obsessive-compulsive symptoms in a non-clinical student population. J Nerv Ment Dis. 2008, 196: 776-779. 10.1097/NMD.0b013e31818786b8.CrossRefPubMed
19.
go back to reference Twohig MP, Hayes SC, Plumb JC, Pruitt LD, Collins AB, Hazlett-Stevens H, Woidneck MR: A randomized clinical trial of acceptance and commitment therapy versus progressive relaxation training for obsessive-compulsive disorder. J Consult Clin Psych. 2010, 78: 705-716.CrossRef Twohig MP, Hayes SC, Plumb JC, Pruitt LD, Collins AB, Hazlett-Stevens H, Woidneck MR: A randomized clinical trial of acceptance and commitment therapy versus progressive relaxation training for obsessive-compulsive disorder. J Consult Clin Psych. 2010, 78: 705-716.CrossRef
20.
go back to reference Hale L, Strauss C, Taylor B: The Effectiveness and Acceptability of Mindfulness-Based Therapy for Obsessive Compulsive Disorder: A Review of the Literature. Mindfulness. 6: 1-8. Hale L, Strauss C, Taylor B: The Effectiveness and Acceptability of Mindfulness-Based Therapy for Obsessive Compulsive Disorder: A Review of the Literature. Mindfulness. 6: 1-8.
21.
go back to reference Goodman WK, Price LH, Rasmussen SA, Mazure C, Fleischmann RL, Hill CL, Heninger GR, Charney DS: The Yale-Brown obsessive compulsive scale: I. Development, use, and reliability. Arch Gen Psychiatry. 1989, 46: 1006-10.1001/archpsyc.1989.01810110048007.CrossRefPubMed Goodman WK, Price LH, Rasmussen SA, Mazure C, Fleischmann RL, Hill CL, Heninger GR, Charney DS: The Yale-Brown obsessive compulsive scale: I. Development, use, and reliability. Arch Gen Psychiatry. 1989, 46: 1006-10.1001/archpsyc.1989.01810110048007.CrossRefPubMed
22.
go back to reference Goodman WK, Price LH, Rasmussen SA, Mazure C, Delgado P, Heninger GR, Charney DS: The yale-brown obsessive compulsive scale: II. Validity. Arch Gen Psychiatry. 1989, 46: 1012-10.1001/archpsyc.1989.01810110054008.CrossRefPubMed Goodman WK, Price LH, Rasmussen SA, Mazure C, Delgado P, Heninger GR, Charney DS: The yale-brown obsessive compulsive scale: II. Validity. Arch Gen Psychiatry. 1989, 46: 1012-10.1001/archpsyc.1989.01810110054008.CrossRefPubMed
23.
go back to reference Wittchen HU, Zaudig M, Fydrich T: SKID-I/II: Users Guide for the Structured Clinical Interview for DSM-IV–German Modified Version. 1997, Göttingen: Hogrefe Wittchen HU, Zaudig M, Fydrich T: SKID-I/II: Users Guide for the Structured Clinical Interview for DSM-IV–German Modified Version. 1997, Göttingen: Hogrefe
24.
go back to reference Smith JA: Qualitative psychology: A practical guide to research methods. Thousand Oaks. 2003, CA US: Sage Publications, Inc Smith JA: Qualitative psychology: A practical guide to research methods. Thousand Oaks. 2003, CA US: Sage Publications, Inc
25.
go back to reference Hsieh H-F, Shannon SE: Three Approaches to Qualitative Content Analysis. Qual Health Res. 2005, 15: 1277-1288. 10.1177/1049732305276687.CrossRefPubMed Hsieh H-F, Shannon SE: Three Approaches to Qualitative Content Analysis. Qual Health Res. 2005, 15: 1277-1288. 10.1177/1049732305276687.CrossRefPubMed
26.
go back to reference Mayring P: Qualitative Inhaltsanalyse. Handbuch qualitative Forschung in der Psychologie. 2010, Wiesbaden: Springer Fachmedien, 601-613.CrossRef Mayring P: Qualitative Inhaltsanalyse. Handbuch qualitative Forschung in der Psychologie. 2010, Wiesbaden: Springer Fachmedien, 601-613.CrossRef
27.
go back to reference Boggatz T, Farid T, Mohammedin A, Dassen T: Attitudes of older Egyptians towards nursing care at home: A qualitative study. J Cross Cult Gerontol. 2009, 24: 33-47. 10.1007/s10823-008-9069-3.CrossRefPubMed Boggatz T, Farid T, Mohammedin A, Dassen T: Attitudes of older Egyptians towards nursing care at home: A qualitative study. J Cross Cult Gerontol. 2009, 24: 33-47. 10.1007/s10823-008-9069-3.CrossRefPubMed
28.
go back to reference Stiglmayr CE, Bischkopf J, Albrecht V, Porzig N, Scheuer S, Lammers C-H, Auckenthaler A: The experience of tension in patients with borderline personality disorder compared to other patient groups and healthy controls. J Soc Clin Psychol. 2008, 27: 425-446. 10.1521/jscp.2008.27.5.425.CrossRef Stiglmayr CE, Bischkopf J, Albrecht V, Porzig N, Scheuer S, Lammers C-H, Auckenthaler A: The experience of tension in patients with borderline personality disorder compared to other patient groups and healthy controls. J Soc Clin Psychol. 2008, 27: 425-446. 10.1521/jscp.2008.27.5.425.CrossRef
29.
go back to reference Külz AK, Lumpp A, Herbst N, Stelzer N, Förstner U, Voderholzer U: Welche Funktionen erfüllen Zwangssymptome?–Ergebnisse einer Analyse im stationären Setting. Verhaltenstherapie. 2010, 20: 101-108.CrossRef Külz AK, Lumpp A, Herbst N, Stelzer N, Förstner U, Voderholzer U: Welche Funktionen erfüllen Zwangssymptome?–Ergebnisse einer Analyse im stationären Setting. Verhaltenstherapie. 2010, 20: 101-108.CrossRef
30.
go back to reference Rees CS, van Koesveld KE: An open trial of group metacognitive therapy for obsessive-compulsive disorder. J Behav Ther Exp Psy. 2008, 39: 451-458. 10.1016/j.jbtep.2007.11.004.CrossRef Rees CS, van Koesveld KE: An open trial of group metacognitive therapy for obsessive-compulsive disorder. J Behav Ther Exp Psy. 2008, 39: 451-458. 10.1016/j.jbtep.2007.11.004.CrossRef
31.
go back to reference Shapiro LJ, Stewart SE: Pathological guilt: A persistent yet overlooked treatment factor in obsessive-compulsive disorder. Ann Clin Psychiatry. 2011, 23: 63-70.PubMed Shapiro LJ, Stewart SE: Pathological guilt: A persistent yet overlooked treatment factor in obsessive-compulsive disorder. Ann Clin Psychiatry. 2011, 23: 63-70.PubMed
32.
go back to reference Valentiner DP, Smith SA: Believing that intrusive thoughts can be immoral moderates the relationship between obsessions and compulsions for shame-prone individuals. Cog Therapy Res. 2008, 32: 714-720. 10.1007/s10608-007-9179-1.CrossRef Valentiner DP, Smith SA: Believing that intrusive thoughts can be immoral moderates the relationship between obsessions and compulsions for shame-prone individuals. Cog Therapy Res. 2008, 32: 714-720. 10.1007/s10608-007-9179-1.CrossRef
33.
go back to reference Bevan A, Oldfield VB, Salkovskis PM: A qualitative study of the acceptability of an intensive format for the delivery of cognitive-behavioural therapy for obsessive-compulsive disorder. Brit J Clin Psychol. 2010, 49: 173-191. 10.1348/014466509X447055.CrossRef Bevan A, Oldfield VB, Salkovskis PM: A qualitative study of the acceptability of an intensive format for the delivery of cognitive-behavioural therapy for obsessive-compulsive disorder. Brit J Clin Psychol. 2010, 49: 173-191. 10.1348/014466509X447055.CrossRef
Metadata
Title
Mindfulness-based cognitive therapy in obsessive-compulsive disorder – A qualitative study on patients’ experiences
Authors
Elisabeth Hertenstein
Nina Rose
Ulrich Voderholzer
Thomas Heidenreich
Christoph Nissen
Nicola Thiel
Nirmal Herbst
Anne Katrin Külz
Publication date
01-12-2012
Publisher
BioMed Central
Published in
BMC Psychiatry / Issue 1/2012
Electronic ISSN: 1471-244X
DOI
https://doi.org/10.1186/1471-244X-12-185

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