DIRT provides hope for OCD hand washers

A new treatment for Obsessive Compulsive Disorder (OCD) pioneered at the University of Sydney is having great success by targeting the beliefs behind the obsessive behaviour rather than the behaviour itself.

OCD currently affects around half a million Australians and can be hugely debilitating, leading to loss of earnings and diminished quality of life for sufferers. Traditionally the disability has been treated with behavioural therapy often combined with powerful drugs which often have negative side effects.

The Danger Ideation Reduction Therapy (DIRT) for Obsessive Compulsive Washers program that was developed by Dr Mairwen Jones and Associate Professor Ross Menzies from the Faculty of Health Sciences at Lidcombe, targets the faulty thinking that people with OCD commonly have that bad things will happen if they don’t repeatedly check.

DIRT consists of six discrete treatment components aimed at reducing the number of intrusive thoughts experienced.

An example of one of the common checking concerns that DIRT deals with is the situation where a person’s fear will cause them to check the iron is switched off or that the front door is locked repeatedly for over an hour before leaving the house, and then half way on their way to work, causing them to turn around and return home to check again. This repetitive behaviour can often take up to many hours out of a person’s day.

To combat this type of behaviour DIRT utilises a number of components such as the probability of catastrophe task. The client will be systematically taken through each of the steps that would be required to take place in order for the negative consequence (such as the house burning down) to occur. They will then calculate probability of all of the steps taking place concurrently (which would be necessary if the feared consequence were to occur).

Trials of DIRT conducted by Dr Jones and colleagues at the University of Sydney with clients who have OCD have shown extremely promising results with recent trials demonstrating DIRT to be more effective than the usual treatment approaches used, particularly for clients with intractable OCD whose symptoms have not been reduced with other treatments. Additionally, unlike pharmacological approaches DIRT does not have the side effects that clients may experience and unlike the behavioural approaches DIRT does not require clients to experience high levels of anxiety for treatment to be successful.

The Sydney team is currently interested in hearing from people with OCD, particularly those who have checking compulsions and check things excessively (for example gas or water taps, lights, doors etc). The treatment trial is free of charge and conducted by an experienced clinical psychologist.

(Source: University of Sydney: June 2008)