An integrative approach to treatment-resistant obsessive-compulsive disorder

Luke Sy Cherng Woon, Anita Kanapathy, Hazli Zakaria, César A. Alfonso

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Obsessive-compulsive disorder (OCD) is a debilitating psychiatric disorder that often runs a chronic unremitting course. Treatment outcomes can be unsatisfactory despite the availability of various somatic and psychological therapies. Psychodynamic psychotherapy in combination with cognitive behavioral therapy (CBT) with exposure and response prevention (ERP) could help patients with treatment-resistant OCD achieve better outcomes. An integrative approach can help patients gain insight, strengthen the therapeutic alliance, improve treatment adherence, and provide symptomatic relief when other treatments seem insufficient or have failed. We describe the treatment process of a person with treatment-resistant OCD who received pharmacotherapy concurrent CBT/ERP, and a brief course of psychodynamic psychotherapy. Case formulations from cognitive behavioral and psychodynamic perspectives are presented. The authors discuss the advantages of doing a psychodynamic assessment and formulation in treatment refractory cases and the wisdom of integrating psychotherapy interventions for OCD, as well as the unique clinical features of cases that warrant a multimodal treatment approach.

Original languageEnglish
Pages (from-to)237-258
Number of pages22
JournalPsychodynamic Psychiatry
Volume45
Issue number2
Publication statusPublished - 1 Jun 2017

Fingerprint

Obsessive-Compulsive Disorder
Psychodynamic Psychotherapy
Cognitive Therapy
Therapeutics
Projective Techniques
Combined Modality Therapy
Psychotherapy
Psychiatry
Psychology
Drug Therapy

Keywords

  • Cognitive behavioral therapy combination of psychotherapies
  • Exposure and response prevention
  • Obsessive-compulsive disorder
  • Psychodynamic psychotherapy treatment resistance

ASJC Scopus subject areas

  • Clinical Psychology
  • Psychiatry and Mental health

Cite this

Woon, L. S. C., Kanapathy, A., Zakaria, H., & Alfonso, C. A. (2017). An integrative approach to treatment-resistant obsessive-compulsive disorder. Psychodynamic Psychiatry, 45(2), 237-258.

An integrative approach to treatment-resistant obsessive-compulsive disorder. / Woon, Luke Sy Cherng; Kanapathy, Anita; Zakaria, Hazli; Alfonso, César A.

In: Psychodynamic Psychiatry, Vol. 45, No. 2, 01.06.2017, p. 237-258.

Research output: Contribution to journalArticle

Woon, LSC, Kanapathy, A, Zakaria, H & Alfonso, CA 2017, 'An integrative approach to treatment-resistant obsessive-compulsive disorder', Psychodynamic Psychiatry, vol. 45, no. 2, pp. 237-258.
Woon, Luke Sy Cherng ; Kanapathy, Anita ; Zakaria, Hazli ; Alfonso, César A. / An integrative approach to treatment-resistant obsessive-compulsive disorder. In: Psychodynamic Psychiatry. 2017 ; Vol. 45, No. 2. pp. 237-258.
@article{0c8d9ade4f6f492b91fa93af2b0f2374,
title = "An integrative approach to treatment-resistant obsessive-compulsive disorder",
abstract = "Obsessive-compulsive disorder (OCD) is a debilitating psychiatric disorder that often runs a chronic unremitting course. Treatment outcomes can be unsatisfactory despite the availability of various somatic and psychological therapies. Psychodynamic psychotherapy in combination with cognitive behavioral therapy (CBT) with exposure and response prevention (ERP) could help patients with treatment-resistant OCD achieve better outcomes. An integrative approach can help patients gain insight, strengthen the therapeutic alliance, improve treatment adherence, and provide symptomatic relief when other treatments seem insufficient or have failed. We describe the treatment process of a person with treatment-resistant OCD who received pharmacotherapy concurrent CBT/ERP, and a brief course of psychodynamic psychotherapy. Case formulations from cognitive behavioral and psychodynamic perspectives are presented. The authors discuss the advantages of doing a psychodynamic assessment and formulation in treatment refractory cases and the wisdom of integrating psychotherapy interventions for OCD, as well as the unique clinical features of cases that warrant a multimodal treatment approach.",
keywords = "Cognitive behavioral therapy combination of psychotherapies, Exposure and response prevention, Obsessive-compulsive disorder, Psychodynamic psychotherapy treatment resistance",
author = "Woon, {Luke Sy Cherng} and Anita Kanapathy and Hazli Zakaria and Alfonso, {C{\'e}sar A.}",
year = "2017",
month = "6",
day = "1",
language = "English",
volume = "45",
pages = "237--258",
journal = "Psychodynamic Psychiatry",
issn = "2162-2590",
publisher = "Guilford Press",
number = "2",

}

TY - JOUR

T1 - An integrative approach to treatment-resistant obsessive-compulsive disorder

AU - Woon, Luke Sy Cherng

AU - Kanapathy, Anita

AU - Zakaria, Hazli

AU - Alfonso, César A.

PY - 2017/6/1

Y1 - 2017/6/1

N2 - Obsessive-compulsive disorder (OCD) is a debilitating psychiatric disorder that often runs a chronic unremitting course. Treatment outcomes can be unsatisfactory despite the availability of various somatic and psychological therapies. Psychodynamic psychotherapy in combination with cognitive behavioral therapy (CBT) with exposure and response prevention (ERP) could help patients with treatment-resistant OCD achieve better outcomes. An integrative approach can help patients gain insight, strengthen the therapeutic alliance, improve treatment adherence, and provide symptomatic relief when other treatments seem insufficient or have failed. We describe the treatment process of a person with treatment-resistant OCD who received pharmacotherapy concurrent CBT/ERP, and a brief course of psychodynamic psychotherapy. Case formulations from cognitive behavioral and psychodynamic perspectives are presented. The authors discuss the advantages of doing a psychodynamic assessment and formulation in treatment refractory cases and the wisdom of integrating psychotherapy interventions for OCD, as well as the unique clinical features of cases that warrant a multimodal treatment approach.

AB - Obsessive-compulsive disorder (OCD) is a debilitating psychiatric disorder that often runs a chronic unremitting course. Treatment outcomes can be unsatisfactory despite the availability of various somatic and psychological therapies. Psychodynamic psychotherapy in combination with cognitive behavioral therapy (CBT) with exposure and response prevention (ERP) could help patients with treatment-resistant OCD achieve better outcomes. An integrative approach can help patients gain insight, strengthen the therapeutic alliance, improve treatment adherence, and provide symptomatic relief when other treatments seem insufficient or have failed. We describe the treatment process of a person with treatment-resistant OCD who received pharmacotherapy concurrent CBT/ERP, and a brief course of psychodynamic psychotherapy. Case formulations from cognitive behavioral and psychodynamic perspectives are presented. The authors discuss the advantages of doing a psychodynamic assessment and formulation in treatment refractory cases and the wisdom of integrating psychotherapy interventions for OCD, as well as the unique clinical features of cases that warrant a multimodal treatment approach.

KW - Cognitive behavioral therapy combination of psychotherapies

KW - Exposure and response prevention

KW - Obsessive-compulsive disorder

KW - Psychodynamic psychotherapy treatment resistance

UR - http://www.scopus.com/inward/record.url?scp=85020855826&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85020855826&partnerID=8YFLogxK

M3 - Article

C2 - 28590207

AN - SCOPUS:85020855826

VL - 45

SP - 237

EP - 258

JO - Psychodynamic Psychiatry

JF - Psychodynamic Psychiatry

SN - 2162-2590

IS - 2

ER -