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ERP to Improve Functioning in Veterans With OCD
Sponsor: VA Office of Research and Development
Summary
Obsessive compulsive disorder (OCD) is a debilitating psychiatric illness impacting work, social, and family functioning. Exposure and Response Prevention (ERP) is the sole evidence-based psychotherapy for OCD; however, no randomized controlled trials (RCTs) have examined the effectiveness of ERP among Veterans or individuals with both OCD and posttraumatic stress disorder (PTSD). This 4-year Hybrid Type I trial will compare outcomes of ERP to those of a control condition among Veterans with OCD. Primary and secondary aims will examine whether Veterans' functioning, quality of life, and OCD symptoms differ between the ERP and control in the full sample of Veterans with OCD, and in the half of the sample with both OCD and PTSD. The tertiary aim is to conduct a mixed-methods formative evaluation of the implementation potential of ERP in VA mental health settings.
Official title: Exposure and Response Prevention to Improve Functioning in Veterans With Obsessive Compulsive Disorder
Key Details
Gender
All
Age Range
18 Years - Any
Study Type
INTERVENTIONAL
Enrollment
160
Start Date
2022-10-03
Completion Date
2026-05-31
Last Updated
2025-11-13
Healthy Volunteers
No
Interventions
Exposure and Response Prevention
ERP is a specialized cognitive behavioral intervention conducted over the course of 8-16 therapy sessions. ERP is based upon exposure principles and the idea that people can habituate to the distress caused by OCD triggers and learn to cope with anxiety about feared consequences without engaging in compulsive behaviors to 'neutralize' the obsession. ERP begins with psychoeducation about OCD and exposure, followed by construction of a hierarchy, or list, of situations that are feared, avoided, or trigger OCD rituals such as washing or checking. Then, the therapist and client begin in-session exposures to hierarchy items utilizing response or ritual prevention techniques to avoid reinforcing the ritual. Exposures can be in vivo, such as touching a contaminated item, or imaginal, such as visualizing a feared consequence happening.
Stress Management Training
The stress management training intervention will be based on that delivered by Simpson in an ERP trial. It will be delivered by PhD and Master's level therapists from each site's clinics. The stress management training intervention will begin with an introductory session providing psychoeducation about OCD, followed by 15 sessions covering stress management skills such as deep breathing progressive muscle relaxation, positive imagery, assertiveness training, and problem solving. Each session will contain an extended practice of the selected skill and will end with homework assignments to practice the stress management skills and monitor symptoms.
Locations (18)
East Orange Campus of the VA New Jersey Health Care System, East Orange, NJ
East Orange, New Jersey, United States
VA Western New York Healthcare System, Buffalo, NY
Buffalo, New York, United States
VA NY Harbor Healthcare System, New York, NY
New York, New York, United States
Northport VA Medical Center, Northport, NY
Northport, New York, United States
James J. Peters VA Medical Center, Bronx, NY
The Bronx, New York, United States
Asheville VA Medical Center, Asheville, NC
Asheville, North Carolina, United States
Durham VA Medical Center, Durham, NC
Durham, North Carolina, United States
Fayetteville VA Medical Center, Fayetteville, NC
Fayetteville, North Carolina, United States
Salisbury W.G. (Bill) Hefner VA Medical Center, Salisbury, NC
Salisbury, North Carolina, United States
VA Roseburg Healthcare System, Roseburg, OR
Roseburg, Oregon, United States
VA Southern Oregon Rehabilitation Center and Clinics, White City, OR
White City, Oregon, United States
Ralph H. Johnson VA Medical Center, Charleston, SC
Charleston, South Carolina, United States
Michael E. DeBakey VA Medical Center, Houston, TX
Houston, Texas, United States
Hampton VA Medical Center, Hampton, VA
Hampton, Virginia, United States
Hunter Holmes McGuire VA Medical Center, Richmond, VA
Richmond, Virginia, United States
Salem VA Medical Center, Salem, VA
Salem, Virginia, United States
Spokane VA Medical Center, Spokane, WA
Spokane, Washington, United States
Jonathan M. Wainwright Memorial VA Medical Center, Walla Walla, WA
Walla Walla, Washington, United States