Improv + ERP Therapy for OCD

Overseen By Study Team

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: Stanford University

Disqualifiers: Active suicidality, Medical illness, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: 12

Duration: 12 weeks

12 Participants Needed

Trial Summary

What is the purpose of this trial?

The goal of this study is to pilot test a novel group therapy intervention for adults with OCD.

Do I need to stop my current medications for the trial?

The trial information does not specify whether you need to stop taking your current medications.

What data supports the effectiveness of the treatment ERP Plus Improv Group Therapy for OCD?

Exposure and response prevention (ERP) therapy is a well-established treatment for OCD, showing significant reductions in symptoms in various studies. Additionally, cognitive-behavioral therapy (CBT), which includes ERP, is effective for OCD, and incorporating cognitive therapy can improve treatment adherence and outcomes. ^{1 2 3 4 5}

How is the ERP Plus Improv treatment for OCD different from other treatments?

ERP Plus Improv is unique because it combines traditional Exposure and Response Prevention Therapy, which helps patients face their fears without performing compulsive behaviors, with improvisational comedy, which encourages creativity and spontaneity, potentially making the therapy more engaging and enjoyable. ^{6 7 8 9 10}

Research Team

Carolyn Rodriguez, MD, PhD

Principal Investigator

Stanford University

Eligibility Criteria

This trial is for adults over 18 who can speak and understand English and have been diagnosed with Obsessive-Compulsive Disorder (OCD). It's not suitable for individuals currently having suicidal thoughts or those with medical or psychiatric conditions that could affect their participation.

Inclusion Criteria

Ability to speak and understand English

I am 18 years old or older.

I have been diagnosed with obsessive-compulsive disorder.

Exclusion Criteria

Current active suicidality

Medical or psychiatric illness that could interfere with study participation

Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants attend 90-minute ERP + improv group therapy sessions for 12 consecutive weeks, complete homework, answer questions, and complete questionnaires.

12 weeks

12 visits (in-person)

Follow-up

Participants are monitored for safety and effectiveness after treatment

4 weeks

Treatment Details

Interventions

• ERP Plus Improv Group Therapy

Trial Overview The study is testing a new group therapy method that combines Exposure Response Prevention (ERP) with improvisational group psychotherapy to see if it helps people with OCD.

Participant Groups

Group I: ERP combined with Improv Group Therapy Experimental Treatment 2 Interventions

Participants will attend 90-minute ERP + improv group therapy sessions for 12 consecutive weeks. They will also complete homework between sessions, answer questions, and complete questionnaires.

Who Is Running the Clinical Trial?

Stanford University

Lead Sponsor

Trials

2,527

Recruited

17,430,000+

Findings from Research

In a study involving 11 patients with obsessive-compulsive disorder (OCD), 64% showed a positive response to home-based exposure and response prevention therapy after 24 sessions.

Of those treated, 36% experienced lasting improvements in their OCD symptoms, suggesting that this approach can be effective in real-world settings.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Home-based behavior therapy for obsessive-compulsive disorder: a case series with data. Rosqvist, J., Egan, D., Manzo, P., et al.[2019]

An Internet-based cognitive-behavioral therapy (ICBT) program for obsessive-compulsive disorder (OCD) was found to be effective, significantly reducing OCD symptoms as measured by the Yale-Brown Obsessive Compulsive Scale (Y-BOCS) in a study of 40 adults over 10 weeks.

Participants reported high satisfaction with ICBT, which was quicker to implement than traditional face-to-face therapy, suggesting that ICBT could be a valuable option to improve access to effective OCD treatment in the United States.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Acceptability, Feasibility, and Effectiveness of Internet-Based Cognitive-Behavioral Therapy for Obsessive-Compulsive Disorder in New York. Patel, SR., Wheaton, MG., Andersson, E., et al.[2020]

Exposure and ritual prevention (EX/RP) is an effective treatment for obsessive-compulsive disorder (OCD), showing significant reductions in symptoms among 110 clinical patients in a real-world outpatient setting.

The outcomes for these clinical patients were comparable to those from four randomized controlled trials, suggesting that EX/RP is beneficial for a broader range of patients, regardless of treatment history or severity of OCD.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Effectiveness of exposure and ritual prevention for obsessive-compulsive disorder: randomized compared with nonrandomized samples. Franklin, ME., Abramowitz, JS., Kozak, MJ., et al.[2009]

Exposure with response prevention (ERP) is established as the first-line psychotherapeutic treatment for obsessive-compulsive disorder (OCD), showing significant efficacy in reducing symptoms.

Combining ERP with cognitive therapy (CT) can enhance treatment outcomes by improving distress tolerance and adherence, suggesting that a tailored approach may be beneficial for patients with OCD.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Efficacy of cognitive-behavioral therapy for obsessive-compulsive disorder. McKay, D., Sookman, D., Neziroglu, F., et al.[2022]

A study involving 177 therapists from the Südbaden Association revealed that most psychotherapists (86.7%) consider the treatment of OCD to be of little relevance in their practice, indicating a potential gap in mental health care for OCD patients.

Less than half of the therapists utilized exposure therapy, the most effective treatment for OCD, primarily due to a lack of experience or training, highlighting the need for improved training and resources in evidence-based treatment strategies.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

[Psychotherapeutic care in OCD outpatients--results from an anonymous therapist survey]. Külz, AK., Hassenpflug, K., Riemann, D., et al.[2022]

A systematic review of 19 clinical trials involving 587 patients found that optical treatments, particularly photodynamic therapy (PDT), can significantly improve inflammatory acne in the short term, with improvements of up to 68%.

While optical treatments show promise, they are not considered first-line therapies for acne vulgaris, and patients should be informed about potential side effects such as pain and hyperpigmentation, especially with treatments involving aminolevulinic acid (ALA) or methyl-aminolevulinic acid (MAL).

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Evidence-based review of lasers, light sources and photodynamic therapy in the treatment of acne vulgaris. Haedersdal, M., Togsverd-Bo, K., Wulf, HC.[2018]

About 50% of surveyed physicians have used patient-delivered therapy (PDT) for nonviral STIs, recognizing its benefits in preventing the spread of infections and re-infection in patients, but only 6% use it frequently.

Despite acknowledging the advantages of PDT, many physicians expressed concerns about practical barriers, such as ensuring medication delivery to partners and potential liability issues, which may hinder its wider adoption.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Physicians' opinions on partner management for nonviral sexually transmitted infections. Niccolai, LM., Winston, DM.[2015]

Photodynamic therapy (PDT) is effective for treating inflammatory acne, with the best results seen using topical 5-aminolaevulinic acid or methyl aminolaevulinate combined with noncoherent light at 2-4 week intervals for a total of two to four treatments.

The treatment is safe for all skin types, but patients with lighter skin (types I-III) have a lower risk of postinflammatory hyperpigmentation compared to those with darker skin, and it can lead to acne remission lasting from 3 months to a year.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The practicalities of photodynamic therapy in acne vulgaris. Taylor, MN., Gonzalez, ML.[2009]

In a study of 95 patients with moderate to severe facial acne, combining photodynamic therapy (PDT) with minocycline resulted in a significantly greater reduction in both inflammatory and noninflammatory lesions compared to minocycline alone after 8 weeks.

Patients receiving the combination treatment also reported a better quality of life, as indicated by a lower Dermatology Life Quality Index score, and experienced only mild and manageable adverse events.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Efficacy of photodynamic therapy combined with minocycline for treatment of moderate to severe facial acne vulgaris and influence on quality of life. Xu, X., Zheng, Y., Zhao, Z., et al.[2022]

A 35-year-old police shooting instructor with Bowen's disease on his right index finger was successfully treated with four cycles of photodynamic therapy (PDT) using two different photosensitizers, resulting in complete clinical and histological clearance of the lesion.

The treatment was effective with minimal downtime from work and no functional or cosmetic deficits, highlighting the safety and efficacy of PDT for Bowen's disease.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Photodynamic therapy for subungual Bowen's disease. Tan, B., Sinclair, R., Foley, P.[2016]

References

1. Netherlands pubmed.ncbi.nlm.nih.gov

Home-based behavior therapy for obsessive-compulsive disorder: a case series with data. [2019]

2. England pubmed.ncbi.nlm.nih.gov

Acceptability, Feasibility, and Effectiveness of Internet-Based Cognitive-Behavioral Therapy for Obsessive-Compulsive Disorder in New York. [2020]

3. United States pubmed.ncbi.nlm.nih.gov

Effectiveness of exposure and ritual prevention for obsessive-compulsive disorder: randomized compared with nonrandomized samples. [2009]

4. Ireland pubmed.ncbi.nlm.nih.gov

Efficacy of cognitive-behavioral therapy for obsessive-compulsive disorder. [2022]

5. Germany pubmed.ncbi.nlm.nih.gov

[Psychotherapeutic care in OCD outpatients--results from an anonymous therapist survey]. [2022]

6. England pubmed.ncbi.nlm.nih.gov

Evidence-based review of lasers, light sources and photodynamic therapy in the treatment of acne vulgaris. [2018]

7. Netherlands pubmed.ncbi.nlm.nih.gov

Physicians' opinions on partner management for nonviral sexually transmitted infections. [2015]

8. England pubmed.ncbi.nlm.nih.gov

The practicalities of photodynamic therapy in acne vulgaris. [2009]

9. United States pubmed.ncbi.nlm.nih.gov

Efficacy of photodynamic therapy combined with minocycline for treatment of moderate to severe facial acne vulgaris and influence on quality of life. [2022]

10. Australia pubmed.ncbi.nlm.nih.gov

Photodynamic therapy for subungual Bowen's disease. [2016]