A Naturalistic Examination of Therapist Experience and Outcome of Exposure and Ritual Prevention for OCD

Abstract

The efficacy of exposure and ritual prevention (EX/RP) for reducing symptoms of obsessive-compulsive disorder (OCD) is well established. However, the question of whether therapist experience with EX/RP influences outcome has yet to be addressed. The authors examined therapist experience and EX/RP outcomes in the context of a specialty training clinic in which adult OCD patients received fee-for-service treatment. Patients treated by 2 groups of therapists with less clinical experience (0-1 year of experience and 2-8 years of experience) had mean posttreatment OCD severity scores comparable to those assigned to the most experienced clinicians (≥9 years of experience). However, reflecting the case assignment methods in this naturalistic study, patients assigned to the most experienced clinicians had more severe OCD at pretreatment. No posttreatment group differences in OCD severity were evident when pretreatment severity score was used as a covariate. Implications of these findings for the development of dissemination research projects are discussed.