Hostname: page-component-78c5997874-fbnjt Total loading time: 0 Render date: 2024-11-05T09:57:15.686Z Has data issue: false hasContentIssue false

A Case of Severe Obsessive–Compulsive Behaviour Treated by Nurse Therapists in an In-Patient Unit*

Published online by Cambridge University Press:  16 June 2009

David J. de L. Horne
Affiliation:
Department of Psychiatry, University of Melbourne, Parkville, Victoria 3052, Australia
Gabriel McTiernan
Affiliation:
Department of Psychiatry, University of Melbourne, Parkville, Victoria 3052, Australia
Nigel H. M. Strauss
Affiliation:
Department of Psychiatry, University of Melbourne, Parkville, Victoria 3052, Australia

Extract

The patient was an 18-year-old girl with a 2-year history of incapacitating Obsessive–compulsive avoidance behaviour for a severe germ phobia. Previous in-patient admissions had failed to produce any improvement. There were no staff in the hospital where she was admitted with any expertise in behaviour therapy so the author was called in as an outside consultant to advise on possible treatment.

A full assessment was made of the patient and the basic behavioural ideas of “modelling”, “flooding” and “avoidance behaviours” were introduced to the entire ward staff. It was decided to employ the ward sisters as the main therapists who were to act as “models”. Target behaviours for change were selected with the patient and baselines obtained before active treatment commenced. Target behaviours were handwashing, time spent in toilet, amount of toilet paper used, rituals before, during, and after showering. In addition, a “germ contamination” hierarchy was constructed. By the 18th week of in-patient treatment, all target behaviours, except going to the toilet to defecate, were under control. This latter behaviour eventually responded well several months later when she was no longer an in-patient. At 2-year follow-up, this girl was entirely free of all “germ” phobias and the associated obsessional avoidance and decontamination rituals.

Type
Research Article
Copyright
Copyright © British Association for Behavioural and Cognitive Psychotherapies 1981

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Grimshaw, L. (1965). The outcome of obsessional disorders. A follow-up study of 100 cases. British Journal of Psychiatry 111, 1511056.CrossRefGoogle ScholarPubMed
Hackman, A. and McLean, C. (1975). A comparison of flooding and thought-stopping in the treatment of obsessional neurosis. Behaviour Research and Therapy 13, 263269.CrossRefGoogle Scholar
Hodgson, R., Rachman, S. J. and Marks, I. M. (1972). The treatment of chronic obsessive–compulsive neurosis: follow-up and further findings. Behaviour Research and Therapy 10, 181189.CrossRefGoogle ScholarPubMed
Marks, I. M., Bird, J. and Lindley, P. (1978). Behavioural nurse therapists 1978–developments and implications. Behavioural Psychotherapy 6, 2536.CrossRefGoogle Scholar
Marks, I. M. et al. (1975). Nurse therapists in behavioural psychotherapy. British Medical Journal 3, 144148.CrossRefGoogle ScholarPubMed
Marks, I. M. et al. (1977). Nursing in Behavioural Psychotherapy. Royal College of Nursing, Research Series, London: Whitefriars Press Ltd.Google Scholar
Rachman, S. J., Hodgson, R. and Marks, I. (1971). Treatment of chronic obsessive–compulsive neurosis. Behaviour Research and Therapy 9, 237247.CrossRefGoogle ScholarPubMed
Rachman, S. J., Marks, I. and Hodgson, R. (1973). The treatment of obsessive–compulsive neurotics by modelling and flooding in vivO. Behaviour Research and Therapy 11, 46471.CrossRefGoogle ScholarPubMed
Submit a response

Comments

No Comments have been published for this article.