The Effectiveness of Mindfulness-integrated Cognitive Behavioral Therapy (MiCBT), Meta-Cognitive Therapy (MCT), Acceptance and Commitment Therapy (ACT), and Cognitive Behavioral Therapy (CBT) on Obsessive-compulsive disorder (OCD)
Authors
-
Ali Derakhtkar
Clinical psychologist, Iran.
https://orcid.org/0000-0002-3481-0429
-
Noshirvan Khezrimoghadam
Associate professor of psychology, Shahid Bahonar University, Kerman,Iran.
https://orcid.org/0000-0003-2112-6158
-
Masoud Fazilatpour
Associate professor of psychology, Shiraz University, Shiraz, Iran.
https://orcid.org/0000-0003-3714-1870
DOI:
https://doi.org/10.22100/ijhs.v8i2.876Keywords:
Obsessive-Compulsive Disorder (OCD), Cognitive Behavioral Therapy (CBT), Acceptance and Commitment Therapy (ACT), Meta-Cognitive Therapy (MCT), Mindfulness-integrated Cognitive Behavioral Therapy (MiCBT)Abstract
Background: Due to the lack of a comparative study on the effectiveness of cognitive-behavioral approaches on Obsessive-compulsive disorder (OCD), this study aimed to compare the effectiveness of CBT, ACT, MCT, and MICBT on the symptoms of OCD patients.
Methods: The research design was experimental, with pre-test, post-test, follow-up, and a control group. The research population comprised patients with OCD who are referred to Shiraz (Iran) Counseling centers in the first quarter of 2017 with a definitive diagnosis of OCD. Participants were elected and had been assigned to five groups of twenty individuals by random. The subjects have been evaluated before and after the intervention by the Yale-Brown questionnaire. Data are analyzed using repeated measure analysis of Anova via SPSS 21.
Results: The findings showed that all four types of intervention, i.e., MiCBT, MCT, ACT, and CBT, were effective in improving short-term OCD symptoms. Also, there was no significant difference in the long-term (follow-up/one month) between the MCT and CBT approaches; while ACT and MiCBT have maintained their therapeutic effect in the follow-up.
Conclusions: OCD can be treated with all the mentioned therapies in short term; but, only ACT and MiCBT can be helpful in the long term.
Keywords: Obsessive-Compulsive Disorder (OCD), Cognitive Behavioral Therapy (CBT), Acceptance and Commitment Therapy (ACT), Meta-Cognitive Therapy (MCT), Mindfulness-integrated Cognitive Behavioral Therapy (MiCBT).
References
2-Whitbourne, S. K., & Halgin, R. P. (2015). Abnormal psychology. McGraw-Hill.
3.Clark, D. M., Fairburn, C. G., & Jones, J. V. (1997). The science and practice of cognitive behaviour therapy. https://doi.org/10/ghwhq5
4.Simon, N. M., Hofmann, S. G., Rosenfield, D., Hoeppner, S. S., Hoge, E. A., Bui, E., & Khalsa, S. B. S. (2021). Efficacy of yoga vs cognitive behavioral therapy vs stress education for the treatment of generalized anxiety disorder: A randomized clinical trial. JAMA Psychiatry, 78(1), 13–20. https://doi.org/10/ghwhqx
5.Asadi, M., Shiralipour, A., Shakouri, Z., & Mohammadkhani, S. (2012). Meta-analysis of the effectiveness of cognitive behavioral therapy (cbt) in treating patients with obsessive-compulsive disorder (Ocd). SSU_Journals, 20(3), 396–405.
6.hamid, n, Ataei Moghanloo, v, & Eidi Bighi, m. (2012). Comparison of the Effectiveness of Three Methods of Cognitive Behavioral Therapy, Drug Therapy and Cognitive Behavioral Therapy combined with Prevention and Response to Improve the Symptoms of Obsessive-Compulsive Disorder. Quarterly Journal of Ghentāshapir, 3(4), 1–12.
7.Olatunji, b o, Davis, m l, Powers, m b, & Smits, j a. (2013). Cognitive-behavioral therapy for obsessive-compulsive disorder: A meta-analysis of therapy outcome and moderators. Journal of Psychiatric Research, 47(1), 33–41. https://doi.org/10/f2g5gg
8.Smith, B. M., Bluett, E. J., Lee, E. B., & Twohig, M. P. (2017). Acceptance and Commitment Therapy for OCD. The Wiley Handbook of Obsessive Compulsive Disorders, 1, 596–613. https://doi.org/10/ghwhq4
9.Hayes, Steven C., Strosahl, K. D., & Wilson, K. G. (2011). Acceptance and commitment therapy: The process and practice of mindful change. Guilford Press.
10.Leeuwerik, T., Cavanagh, K., Forrester, E., Hoadley, C., Jones, A.-M., Lea, L., Rosten, C., & Strauss, C. (2020). Participant perspectives on the acceptability and effectiveness of mindfulness-based cognitive behaviour therapy approaches for obsessive compulsive disorder. PloS One, 15(10), e0238845. https://doi.org/10/ghwhq6
11.Goubert, D. P., Törneke, N., Purssey, R., Loftus, J., Roberts, L. W., & Strosahl, K. D. (2020). Learning Acceptance and Commitment Therapy: The Essential Guide to the Process and Practice of Mindful Psychiatry. American Psychiatric Pub.
12.Bach, P. A., & Moran, D. J. (2008). ACT in practice: Case conceptualization in acceptance and commitment therapy. New Harbinger Publications.
13.Twohig, m p, Hayes, s c, & Masuda, a. (2006). Increasing willingness to experience obsessions: Acceptance and commitment therapy as a therapy for obsessive-compulsive disorder. 37(3), 1–13. https://doi.org/10/cnpgc5
14.Hayes, S. C., Luoma, J. B., Bond, F. W., Masuda, A., & Lillis, J. (2006). Behaviour research and therapy. Behav Res Ther, 44, 1–25. https://doi.org/10/dp332g
15.Vakili, Y., & Gharraee, B. (2014). The effectiveness of acceptance and commitment therapy in treating a case of obsessive compulsive disorder. Iranian Journal of Psychiatry, 9(2), 115.
16.Landy, L. N., Schneider, R. L., & Arch, J. J. (2015). Acceptance and commitment therapy for the treatment of anxiety disorders: A concise review. Current Opinion in Psychology, 2, 70–74. https://doi.org/10/ggnk32
17.Fisher, P., & Wells, A. (2009). Metacognitive therapy: Distinctive features (Vol. 1). Routledge.
18.Van der Heiden, c, van Rossen, k, Dekker, a, Damstra, m, & Deen, m. (2016). Metacognitive therapy for obsessive–compulsive disorder: A pilot study. Journal of Obsessive-Compulsive and Related Disorders, 9, 24–29. https://doi.org/10/ghwhqz
19.Wells, a. (2011). Metacognitive therapy for anxiety and depression (Vol. 1). Guilford press.
20.ashoori, khalghi Dehnavi, f, & safari, m. (2014). The Effect of Metacognitive Therapy on Marital Satisfaction. Woman and family studies. Woman and family studies, 24(6), 53–65.
21.Rajezi Isfahani, s, Fata, l, Hasanabadi, h, Yaghoubi, h, Zahiruddin, a, Sadr, s, Mahdavi, n, & Nourbakhsh, s. (2016). Meta-cognitive Therapy in Reducing Signs and Increasing Functional Level in Obsessive Compulsive Disorder: A Case Study. Rehabilitation Medicine, 5(2), 40–51.
22.Esbjørn, B. H., Normann, N., Christiansen, B. M., & Reinholdt-Dunne, M. L. (2018). The efficacy of group metacognitive therapy for children (MCT-c) with generalized anxiety disorder: An open trial. Journal of Anxiety Disorders, 53, 16–21. https://doi.org/10/gcxf9d
23.McEvoy, P. M., Erceg-Hurn, D. M., Anderson, R. A., Campbell, B. N., & Nathan, P. R. (2015). Mechanisms of change during group metacognitive therapy for repetitive negative thinking in primary and non-primary generalized anxiety disorder. Journal of Anxiety Disorders, 35, 19–26. https://doi.org/10/f7zcn6
24.Cayoun, B. A. (2011). Mindfulness-integrated CBT: Principles and practice. John Wiley & Sons.
25.Kumar, A., Sharma, M. P., Narayanaswamy, J. C., Kandavel, T., & Reddy, Y. J. (2016). Efficacy of mindfulness-integrated cognitive behavior therapy in patients with predominant obsessions. Indian Journal of Psychiatry, 58(4), 366. https://doi.org/10/f9mnwk
26.Farzinrad, B., & Kamal, m n. (2013, September). Comparison between Effectiveness of mindfulness integrated cognitive behavioral therapy (MiCBT) and rational emotional behavior therapy (REBT) on procrastination, perfectionism and worry in students. Tabriz University of medical sciences. In 6th International Congress on Child and Adolescent Psychiatry, tabriz, iran .
27.Yazdanimehr, R., Omidi, A., Sadat, Z., & Akbari, H. (2016). The effect of mindfulness-integrated cognitive behavior therapy on depression and anxiety among pregnant women: A randomized clinical trial. Journal of Caring Sciences, 5(3), 195. https://doi.org/10/gbrvd3
28.Michaeli Barzili, n, Ahadi, b, & Hassanabadi, h. (2011). Comparison of the Effect of Islamic Therapy and Cognitive-Behavioral Therapy in Patients with Obsessive-Compulsive Disorder. Psychological Achievements (Educational Sciences and Psychology), 18(2), 61–86.
29.Sajatovic, m, & Ramirez, l. (2003). Geriatric Depression Scale (GDS). Rating Scales in Mental Health. Hudson, Oh: Lexi-Comp, Inc, 405–406.
30.Goodman, W. K., Price, L. H., Rasmussen, S. A., Mazure, C., Fleischmann, R. L., & Hill, C. L. (n.d.). & Charney, DS (1989). Yale-brown obsessive compulsive scale (Y-BOCS). Arch Gen Psychiatry, 46, 1006–1011. https://doi.org/10/bvgvrf
31.Whittal, M. L., & McLean, P. D. (1999). CBT for OCD: The rationale, protocol, and challenges. Cognitive and Behavioral Practice, 6(4), 383–396. https://doi.org/10/dmjcxr
32.Cayoun, B. A. (2014). Mindfulness-integrated CBT for well-being and personal growth: Four steps to enhance inner calm, self-confidence and relationships. John Wiley & Sons.
33.Bluett, E. J., Homan, K. J., Morrison, K. L., Levin, M. E., & Twohig, M. P. (2014). Acceptance and commitment therapy for anxiety and OCD spectrum disorders: An empirical review. Journal of Anxiety Disorders, 28(6), 612–624. https://doi.org/10/f6d266
34.Tavakoli, s, & Ghassemzadeh, h. (2006). Cognitive- Behavioral Theories and Treatments of Obsessive- Compulsive Disorder. Advances in Cognitive Sciences, 8(1), 54–76. http://icssjournal.ir/article-1-322-fa.html
35.Khadayari Fard, m, & Abedini, y. (2001). Comparison of the Effectiveness of Cognitive-Behavioral Therapy and Cognitive-Therapeutic Behavioral Therapy in Patients with Obsessive-Compulsive Disorder. Psychology and Educational Sciences, 31(1), 145–179.
36.Bajaj, B., & Pande, N. (2016). Mediating role of resilience in the impact of mindfulness on life satisfaction and affect as indices of subjective well-being. Personality and Individual Differences, 93, 63–67. https://doi.org/10/f8cbvs
37.Bazarko, D., Cate, R. A., Azocar, F., & Kreitzer, M. J. (2013). The impact of an innovative mindfulness-based stress reduction program on the health and well-being of nurses employed in a corporate setting. Journal of Workplace Behavioral Health, 28(2), 107–133. https://doi.org/10/ggvrp5
38.Carmody, J., Reed, G., Kristeller, J., & Merriam, P. (2008). Mindfulness, spirituality, and health-related symptoms. Journal of Psychosomatic Research, 64(4), 393–403. https://doi.org/10/bh23f9
39.Hwang, H., Bae, S., Hong, J. S., & Han, D. H. (2021). Comparing Effectiveness Between a Mobile App Program and Traditional Cognitive Behavior Therapy in Obsessive-Compulsive Disorder: Evaluation Study. JMIR Mental Health, 8(1), e23778. https://doi.org/10/ghwhq2
40.Miegel, F., Demiralay, C., Moritz, S., Wirtz, J., Hottenrott, B., & Jelinek, L. (2020). Metacognitive training for obsessive-compulsive disorder: A study protocol for a randomized controlled trial. BMC Psychiatry, 20(1), 1–13. https://doi.org/10/ghwhqw
41..Mohammadi, a, Zargar, f, Omidi, a, Mehrabi, a, Akbari, m, & Bagholi, h. (2016). Introduction to the Third Generation of Cognitive Therapies (Vol. 1). Arjmand.
3.Clark, D. M., Fairburn, C. G., & Jones, J. V. (1997). The science and practice of cognitive behaviour therapy. https://doi.org/10/ghwhq5
4.Simon, N. M., Hofmann, S. G., Rosenfield, D., Hoeppner, S. S., Hoge, E. A., Bui, E., & Khalsa, S. B. S. (2021). Efficacy of yoga vs cognitive behavioral therapy vs stress education for the treatment of generalized anxiety disorder: A randomized clinical trial. JAMA Psychiatry, 78(1), 13–20. https://doi.org/10/ghwhqx
5.Asadi, M., Shiralipour, A., Shakouri, Z., & Mohammadkhani, S. (2012). Meta-analysis of the effectiveness of cognitive behavioral therapy (cbt) in treating patients with obsessive-compulsive disorder (Ocd). SSU_Journals, 20(3), 396–405.
6.hamid, n, Ataei Moghanloo, v, & Eidi Bighi, m. (2012). Comparison of the Effectiveness of Three Methods of Cognitive Behavioral Therapy, Drug Therapy and Cognitive Behavioral Therapy combined with Prevention and Response to Improve the Symptoms of Obsessive-Compulsive Disorder. Quarterly Journal of Ghentāshapir, 3(4), 1–12.
7.Olatunji, b o, Davis, m l, Powers, m b, & Smits, j a. (2013). Cognitive-behavioral therapy for obsessive-compulsive disorder: A meta-analysis of therapy outcome and moderators. Journal of Psychiatric Research, 47(1), 33–41. https://doi.org/10/f2g5gg
8.Smith, B. M., Bluett, E. J., Lee, E. B., & Twohig, M. P. (2017). Acceptance and Commitment Therapy for OCD. The Wiley Handbook of Obsessive Compulsive Disorders, 1, 596–613. https://doi.org/10/ghwhq4
9.Hayes, Steven C., Strosahl, K. D., & Wilson, K. G. (2011). Acceptance and commitment therapy: The process and practice of mindful change. Guilford Press.
10.Leeuwerik, T., Cavanagh, K., Forrester, E., Hoadley, C., Jones, A.-M., Lea, L., Rosten, C., & Strauss, C. (2020). Participant perspectives on the acceptability and effectiveness of mindfulness-based cognitive behaviour therapy approaches for obsessive compulsive disorder. PloS One, 15(10), e0238845. https://doi.org/10/ghwhq6
11.Goubert, D. P., Törneke, N., Purssey, R., Loftus, J., Roberts, L. W., & Strosahl, K. D. (2020). Learning Acceptance and Commitment Therapy: The Essential Guide to the Process and Practice of Mindful Psychiatry. American Psychiatric Pub.
12.Bach, P. A., & Moran, D. J. (2008). ACT in practice: Case conceptualization in acceptance and commitment therapy. New Harbinger Publications.
13.Twohig, m p, Hayes, s c, & Masuda, a. (2006). Increasing willingness to experience obsessions: Acceptance and commitment therapy as a therapy for obsessive-compulsive disorder. 37(3), 1–13. https://doi.org/10/cnpgc5
14.Hayes, S. C., Luoma, J. B., Bond, F. W., Masuda, A., & Lillis, J. (2006). Behaviour research and therapy. Behav Res Ther, 44, 1–25. https://doi.org/10/dp332g
15.Vakili, Y., & Gharraee, B. (2014). The effectiveness of acceptance and commitment therapy in treating a case of obsessive compulsive disorder. Iranian Journal of Psychiatry, 9(2), 115.
16.Landy, L. N., Schneider, R. L., & Arch, J. J. (2015). Acceptance and commitment therapy for the treatment of anxiety disorders: A concise review. Current Opinion in Psychology, 2, 70–74. https://doi.org/10/ggnk32
17.Fisher, P., & Wells, A. (2009). Metacognitive therapy: Distinctive features (Vol. 1). Routledge.
18.Van der Heiden, c, van Rossen, k, Dekker, a, Damstra, m, & Deen, m. (2016). Metacognitive therapy for obsessive–compulsive disorder: A pilot study. Journal of Obsessive-Compulsive and Related Disorders, 9, 24–29. https://doi.org/10/ghwhqz
19.Wells, a. (2011). Metacognitive therapy for anxiety and depression (Vol. 1). Guilford press.
20.ashoori, khalghi Dehnavi, f, & safari, m. (2014). The Effect of Metacognitive Therapy on Marital Satisfaction. Woman and family studies. Woman and family studies, 24(6), 53–65.
21.Rajezi Isfahani, s, Fata, l, Hasanabadi, h, Yaghoubi, h, Zahiruddin, a, Sadr, s, Mahdavi, n, & Nourbakhsh, s. (2016). Meta-cognitive Therapy in Reducing Signs and Increasing Functional Level in Obsessive Compulsive Disorder: A Case Study. Rehabilitation Medicine, 5(2), 40–51.
22.Esbjørn, B. H., Normann, N., Christiansen, B. M., & Reinholdt-Dunne, M. L. (2018). The efficacy of group metacognitive therapy for children (MCT-c) with generalized anxiety disorder: An open trial. Journal of Anxiety Disorders, 53, 16–21. https://doi.org/10/gcxf9d
23.McEvoy, P. M., Erceg-Hurn, D. M., Anderson, R. A., Campbell, B. N., & Nathan, P. R. (2015). Mechanisms of change during group metacognitive therapy for repetitive negative thinking in primary and non-primary generalized anxiety disorder. Journal of Anxiety Disorders, 35, 19–26. https://doi.org/10/f7zcn6
24.Cayoun, B. A. (2011). Mindfulness-integrated CBT: Principles and practice. John Wiley & Sons.
25.Kumar, A., Sharma, M. P., Narayanaswamy, J. C., Kandavel, T., & Reddy, Y. J. (2016). Efficacy of mindfulness-integrated cognitive behavior therapy in patients with predominant obsessions. Indian Journal of Psychiatry, 58(4), 366. https://doi.org/10/f9mnwk
26.Farzinrad, B., & Kamal, m n. (2013, September). Comparison between Effectiveness of mindfulness integrated cognitive behavioral therapy (MiCBT) and rational emotional behavior therapy (REBT) on procrastination, perfectionism and worry in students. Tabriz University of medical sciences. In 6th International Congress on Child and Adolescent Psychiatry, tabriz, iran .
27.Yazdanimehr, R., Omidi, A., Sadat, Z., & Akbari, H. (2016). The effect of mindfulness-integrated cognitive behavior therapy on depression and anxiety among pregnant women: A randomized clinical trial. Journal of Caring Sciences, 5(3), 195. https://doi.org/10/gbrvd3
28.Michaeli Barzili, n, Ahadi, b, & Hassanabadi, h. (2011). Comparison of the Effect of Islamic Therapy and Cognitive-Behavioral Therapy in Patients with Obsessive-Compulsive Disorder. Psychological Achievements (Educational Sciences and Psychology), 18(2), 61–86.
29.Sajatovic, m, & Ramirez, l. (2003). Geriatric Depression Scale (GDS). Rating Scales in Mental Health. Hudson, Oh: Lexi-Comp, Inc, 405–406.
30.Goodman, W. K., Price, L. H., Rasmussen, S. A., Mazure, C., Fleischmann, R. L., & Hill, C. L. (n.d.). & Charney, DS (1989). Yale-brown obsessive compulsive scale (Y-BOCS). Arch Gen Psychiatry, 46, 1006–1011. https://doi.org/10/bvgvrf
31.Whittal, M. L., & McLean, P. D. (1999). CBT for OCD: The rationale, protocol, and challenges. Cognitive and Behavioral Practice, 6(4), 383–396. https://doi.org/10/dmjcxr
32.Cayoun, B. A. (2014). Mindfulness-integrated CBT for well-being and personal growth: Four steps to enhance inner calm, self-confidence and relationships. John Wiley & Sons.
33.Bluett, E. J., Homan, K. J., Morrison, K. L., Levin, M. E., & Twohig, M. P. (2014). Acceptance and commitment therapy for anxiety and OCD spectrum disorders: An empirical review. Journal of Anxiety Disorders, 28(6), 612–624. https://doi.org/10/f6d266
34.Tavakoli, s, & Ghassemzadeh, h. (2006). Cognitive- Behavioral Theories and Treatments of Obsessive- Compulsive Disorder. Advances in Cognitive Sciences, 8(1), 54–76. http://icssjournal.ir/article-1-322-fa.html
35.Khadayari Fard, m, & Abedini, y. (2001). Comparison of the Effectiveness of Cognitive-Behavioral Therapy and Cognitive-Therapeutic Behavioral Therapy in Patients with Obsessive-Compulsive Disorder. Psychology and Educational Sciences, 31(1), 145–179.
36.Bajaj, B., & Pande, N. (2016). Mediating role of resilience in the impact of mindfulness on life satisfaction and affect as indices of subjective well-being. Personality and Individual Differences, 93, 63–67. https://doi.org/10/f8cbvs
37.Bazarko, D., Cate, R. A., Azocar, F., & Kreitzer, M. J. (2013). The impact of an innovative mindfulness-based stress reduction program on the health and well-being of nurses employed in a corporate setting. Journal of Workplace Behavioral Health, 28(2), 107–133. https://doi.org/10/ggvrp5
38.Carmody, J., Reed, G., Kristeller, J., & Merriam, P. (2008). Mindfulness, spirituality, and health-related symptoms. Journal of Psychosomatic Research, 64(4), 393–403. https://doi.org/10/bh23f9
39.Hwang, H., Bae, S., Hong, J. S., & Han, D. H. (2021). Comparing Effectiveness Between a Mobile App Program and Traditional Cognitive Behavior Therapy in Obsessive-Compulsive Disorder: Evaluation Study. JMIR Mental Health, 8(1), e23778. https://doi.org/10/ghwhq2
40.Miegel, F., Demiralay, C., Moritz, S., Wirtz, J., Hottenrott, B., & Jelinek, L. (2020). Metacognitive training for obsessive-compulsive disorder: A study protocol for a randomized controlled trial. BMC Psychiatry, 20(1), 1–13. https://doi.org/10/ghwhqw
41..Mohammadi, a, Zargar, f, Omidi, a, Mehrabi, a, Akbari, m, & Bagholi, h. (2016). Introduction to the Third Generation of Cognitive Therapies (Vol. 1). Arjmand.
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2021-10-10
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How to Cite
The Effectiveness of Mindfulness-integrated Cognitive Behavioral Therapy (MiCBT), Meta-Cognitive Therapy (MCT), Acceptance and Commitment Therapy (ACT), and Cognitive Behavioral Therapy (CBT) on Obsessive-compulsive disorder (OCD). (2021). International Journal of Health Studies (Undergoing Change to Shahroud Journal of Medical Sciences), 8(2), 46-52. https://doi.org/10.22100/ijhs.v8i2.876
