Psychosocial interventions for obsessive compulsive disorder

Use psychosocial interventions first line for the management of obsessive compulsive disorder (OCD). Initial treatment includes psychoeducation. Because symptoms frequently impact people living or working with the person with OCD, psychoeducation and support for family, carers or significant others are also important.

Many patients, particularly those with more severe symptoms, cannot engage in psychosocial interventions until they have an initial response to pharmacotherapy.

Cognitive behavioural therapy (CBT) with an exposure and response prevention (ExRP) component is the treatment of choice. This includes 2 key elements: exposure to the cues or triggers that cause anxiety and strategies to prevent acting on compulsions. For children, adapt CBT to their chronological and developmental age.

There is also limited evidence for acceptance and commitment therapy, family intervention and mindfulness-based cognitive therapy.