Symposium
Obsessive Compulsive and Related Disorders
Jessica Grisham, Ph.D. (she/her/hers)
Professor
UNSW Sydney
Sydney, New South Wales, Australia
Natalie Winiarski, student (she/her/hers)
Clinical Masters student in the School of Psychology
University of new south wales
Kensington, New South Wales, Australia
David Cooper, dr (he/him/his)
Adjunct Lecturer in the School of Psychiatry
University of new south wales
Kensington, New South Wales, Australia
Dua Kashany, student (she/her/hers)
Clinical Masters student in the School of Psychology
University of new south wales
Kensington, New South Wales, Australia
Alison Mahoney, Ph.D.
Senior Clinical Psychologist, Director of Clinical Research
Clinical Research Unit for Anxiety and Depression, St Vincents Hospital
Sydney, New South Wales, Australia
Jenny Le, Dr (she/her/hers)
Clinical Psychologist
Clinical Research Unit for Anxiety and Depression (CRUfAD)
Darlinghurst, New South Wales, Australia
Shyn Phua, , UNSW, Female, student (she/her/hers)
Clinical Masters student in the School of Psychology
University of new south wales
Kensington, New South Wales, Australia
Intrusive mental imagery is a core phenomenological feature of OCD that is not addressed by standard CBT. Imagery rescripting is an approach that uses imagery to address implicit maladaptive cognitions encapsulated within early experiences. Because access to existing therapist-guided interventions for OCD is limited by barriers such as a lack of treatment providers, cost, shame, and stigma, we investigated the feasibility, acceptability, and preliminary efficacy of online audio-guided imagery rescripting as a treatment adjunct to an established self-guided iCBT program. We hypothesised that (1) the audio-guided imagery rescripting intervention could be feasibly and acceptably be incorporated as an adjunct to the iCBT program; (2) participants would report significant decreases in OCD symptoms from baseline to 1-month follow-up, which would be maintained at 3- and 6-month follow-up (3) greater visual imagery ability would predict more improvement in OCD symptoms.
Methods:
Participants (N =21) with OCD completed a self-guided iCBT program developed by and delivered via THIS WAY UP (https://thiswayup.org.au/). The iCBT program was followed by three 30-minute audio-guided imagery rescripting sessions. Each audio-guided exercise comprised a brief psychoeducation section about the rationale for using imagery rescripting, followed by a three-phase imagery rescripting procedure based on Arntz and Weertman’s (1999) guidelines for rescripting childhood memories. We assessed OCD symptoms at baseline (pre-imagery rescripting), post-imagery rescripting and at 1-, 3- and 6-months post-treatment, alongside collecting qualitative feedback. In addition, we examined visual imagery ability as a predictor of treatment response to imagery rescripting.
Results:
Feasibility and acceptability of the rescripting intervention were demonstrated by low dropout rates and positive quantitative and qualitative feedback. OCD symptoms did not significantly improve at post-intervention; however, OCD severity at 6-month follow-up indicated a significant improvement from baseline. When OCD symptom dimensions were examined separately, only the repugnant dimension showed significant reductions post-intervention and 3-month follow-up. Consistent with hypotheses, greater baseline visual imagery ability was associated with a larger improvement in OCD severity at 1- and 6-month follow-up.
Conclusions:
These results pave the way for further development and evaluation of imagery-enhanced online treatments for OCD.