Obsessive Compulsive Disorder (OCD) is characterised by recurrent obsessions (thoughts, images, impulses that are deemed to be intrusive, unacceptable, uncontrollable and ego dystonic) and compulsions (repetitive behaviours that can be overt or covert, E. G .excessive hand washing or ruminations) (DSM 5. 2013) The main psychological treatment paradigm for OCD is Cognitive Behavioural Psychotherapy (CBP), (NICE 2005, Salkovskis 2008, Deacon et al 2004). However it must be acknowledged that whilst CBP can be effective, not all clients respond well to CBP and even when they do the level of improvement varies (Roth 2006). Rector et al (2009) report high “drop out” rates of up to 40% of people suffering from OCD and receiving CBP. Various studies have demonstrated that interventions that focus upon the way clients appraise the content of their obsessive thoughts, rather than focussing on the thought itself, produce better and longer lasting results (Salkovskis 2008; Deakon et al 2004; Clark 2000 & Rackman 1993) The focus on the clients appraisals of their thoughts, over responsibility (Salkovskis 1998), Issues surrounding control (Clark 2001) and issues surrounding safety (Rachman 1998) rather than fussing on the behaviours and compulsions themselves allows for other forms of psychological interventions such as EMDR to be considered.
Methodology and Analysis:
Series case design (N=8): Psychometric measures: Yale- Brown Obsessive Compulsive Inventory (Goorman et al 1989); PHQ-9 (Kroenke et al 2001) and GAD-7 (Spitzer et al 2006). The DES (Bernstein & Putman 1986) was routinely administered as per EMDR safe practice.
Adults between the ages of 18-65 who carry a diagnosis of OCD and who have received CBP within the previous five years but are still experiencing symptoms, will be offered assessment and eight secessions of EMDR (in an effort to replicate IAPT services), followed by one and three month follow up appointments (no EMDR will be used at follow up). Normal EMDR protocol will be used for clients with past aversive life experiences (PALE) normal EMDR focussing on Intolerance of Uncertainty for those where no PALE was identified.
Significant improvement noted across all psychometric measures at three month follow up , also self- reported positive behavioural change reported by subjects.
Paul Keenan is a European accredited Consultant in EMDR. He is an accredited Cognitive Behavioural Psychotherapist /Trainer and Supervisor with the British Association of Behavioural and Cognitive Psychotherapists. He is currently employed as a Senior Lecturer in Mental Health at Edge Hill University, Liverpool, UK. Paul has been practising EMDR since the early 90’s, he has presented at various national and international EMDR conferences on trauma and the combination of CBT and EMDR, he has also published on a variety of topics including, morbid jealousy, stigma, and vicarious traumatisation. As a member of the Humanitarian Assistance Programme (HAP), he has helped train clinicians to treat psychological trauma in Turkey in 1999, following the earthquake and India in 2005, following the tsunami. He is currently part of the team, working in Pakistan, following the earthquake in 2005.Other current research projects involve using a Q methodological approach to examine the interface between EMDR and CBP, a study exploring the utilisation of slow Bilateral stimulation in phase (2) “safe place exercise”, in EMDR and also an ongoing International Delphi study examining expert views on EMDR training standards and methods. Paul is married with three children and two grandchildren.
Lynn has over 30yrs experience of working within the field of mental health. She is an Accredited Cognitive Behavioural Psychotherapist and a European Accredited EMDR Consultant and Facilitator and a Registered Mental Nurse. Lynn has an MSc in Addiction and Substance Use, a Post Graduate Diploma in Cognitive Behavioural Psychotherapy and a Diploma of Higher Education in Community Health. Lynn is also an associate Lecturer at Edgehill University, Ormskirk and regularly teaches on the Master’s programme for Cognitive Behavioural Therapy, Under Graduate Mental Health courses and on the Pre - Registered Nursing programme for Mental Health Nursing. Lynn provides cognitive behavioural therapy and EMDR for a range of psychological problems. She has a special interest in Psychological Trauma and has delivered presentations at International, European and National conferences in EMDR, and workshops for the local branch of the British Association of Behavioural and Cognitive Psychotherapists. She is a co-author on two publications and currently has a paper in press. Lynn also provides clinical supervision for therapists practising cognitive behavioural therapy at both low and high intensity levels and for EMDR practitioners at all levels including, accredited practitioners and fellow EMDR Consultants. Lynn is a member of the Humanity Assistance Programme and has taken an active role in delivering EMDR Training for mental health professionals in Pakistan following the earthquake in 2008 which killed 88,000 people.