- Year read:#read2022
- Subject: _thesis defense MOC OCD ASD CBT
- Bibtex: @flygare2020
- Bibliography: Flygare, O., Andersson, E., Ringberg, H., Hellstadius, A.-C., Edbacken, J., Enander, J., Dahl, M., Aspvall, K., Windh, I., Russell, A., Mataix-Cols, D., & Rück, C. (2020). Adapted cognitive behavior therapy for obsessive–compulsive disorder with co-occurring autism spectrum disorder: A clinical effectiveness study. Autism, 24(1), 190–199. https://doi.org/10.1177/1362361319856974
Adapted CBT for OCD and ASD - response to reviewer comments
- Low engagement with trt
- Yes, this was a challenge. There is more work to do for these patients, and a couple of ideas are to provide more in-home support in between sessions and try a concentrated mode of delivery. You could also aim at other outcomes than symptom reduction.
- Adequate dose of CBT?
- Treatment was spread out and they didn’t do that many ERP exercises compared to what we expected, so its likely they got a lower dose of ERP than what would have been optimal.
- Therapist change
- Yes, likely a side-effect of the spread out sessions. I think this would have been much lower if treatment was delivered more consistently.
- No control group
- Yeah we cannot rule out trt effects due to the passage of time or other circumstances beyond the treatment itself. However, spontaneous remission is unlikely for these patients.
- Sample size
- It was enough to detect large treatment effects at least, but it would have been an insufficient sample size had we compared to another treatment.
- OCD/ASD symptom overlap
- Phenomenological overlap (repetitive behaviors), but functionally different (anxiety reduction in OCD vs pleasurable repetitive activities in ASD)
- ASD-related differences and difficulties in sessions (sensory issues, generalizing, slower habituation, identifying/labeling/grading emotional response)
- There were some adaptations, like additional psychoeducation around emotions and grading them, visual guidance, more involvement of family and others. First 5 sessions were setup, which is longer than usual (~2 sessions)