Processes of change in psychological flexibility in an interdisciplinary group-based treatment for OCD based on Acceptance and CommitmentTherapy

There are now numerous studies of Acceptance and Commitment Therapy (ACT) for OCD. These studies provide growing support for the efficacy and effectiveness of ACT in thiscontext as well as for the role of ACT-specific therapeutic processes, particularly those underlying psychological flexibility. The purpose of the present study was to continue to build on this work with a broader focus on these processes, including acceptance of thoughts,general psychological acceptance, mindfulness, and values based action. Participants included 30 patients who completed an ACT-based treatment for OCD and a Six-monthfollow-up. Following treatment and at follow-up, participants reported significantly reduced levels of obsessive and compulsive actions, depression, pain-related anxiety, physical and psychosocial disability, and thought intensity in comparison to the start of treatment. Theyalso showed significant increases in each of the processes of psychological flexibility. Most uncontrolled effect sizes were medium or large at the follow-up. In correlation analyses changes in the four processes measures generally were significantly related to changes in themeasures of obsessive and compulsive actions, depression, anxiety, and disability. In regression analyses the combined processes were related to changes in outcomes above and beyond change in thought intensity. Although in some ways preliminary, these results specifically support the unique role of general psychological acceptance in relation to improvements achieved by treatment participants. The current study clarifies potentialprocesses of change in treatment for OCD, particularly those aiming to enhance psychological flexibility