Third-wave, Mindfulness-based Therapies as Treatments for Obsessive-compulsive Disorder: a Randomized Controlled Trial

Obsessive-compulsive disorder (OCD) is a severe, difficult-to-treat neuropsychiatric condition that affects millions of people throughout the world. The current first-line psychotherapy for OCD is exposure and response prevention (ERP). ERP is effective but flawed, and researchers seek alternative OCD treatments. We examined two third-wave, mindfulness-based therapies (1) acceptance and commitment therapy (ACT) and (2) mindfulness-based cognitive therapy (MBCT) as treatments for OCD. We expected ACT/MBCT to have (1a) significantly higher OCD symptom reduction rates, (1b) higher treatment response rates, and (1c) lower dropout rates than a control (progressive relaxation training/PRT), as well as (2a) equal/higher OCD symptom reduction rates, (2b) equal/higher treatment response rates, and (2c) lower drop-out rates than ERP. One hundred participants diagnosed with DSM-IV-TR OCD participated in an eight-session, between-subjects, randomized controlled trial (RCT). Participants were randomly assigned across the four conditions evenly. Treatment effectiveness was tested using one-way ANOVA. Results indicated the following. OCD symptom reduction: ACT (M = 41.30%, SD = 16.30%), MBCT (M = 35.89%, SD = 11.99%), PRT (M = 27.26%, SD = 9.66%), ERP (M = 30.30%, SD = 12.03%); only significant differences were ACT/PRT, p < .01. Treatment response: ACT (54.17%), MBCT (41.67%), PRT (12.50%), ERP (32.00%). Dropout: ACT (16.00%), MBCT (13.04%), PRT (16.67%), ERP (28.00%). Results suggest ACT may be an effective OCD treatment compared to a control, whereas MBCT may not be, and that both ACT and MBCT may be viable alternatives to the current first-line psychotherapy for OCD. This contradiction is explained by factors outlined in the paper.