Stages of change and the treatment of OCD

• Motivation as measured by stages of change predicts treatment outcome in several psychiatric disorders.
• This study examined motivation in relation to outcome following residential CBT treatment for OCD.
• Results suggest that low motivation at admission and one month follow-up is related to poorer outcome in OCD.

The Stages of Change model conceptualizes the process of behavioral change. The University of Rhode Island Change Assessment (URICA) is a self-report measure divided into subscales that represent four of the five different stages (Precontemplation, Contemplation, Action, and Maintenance). Research has shown that higher Precontemplation scores predict reduced treatment response in anxiety disorders. The purpose of this investigation was to examine the role of the stages of change in treatment outcomes with individuals with OCD undergoing intensive residential treatment including exposure therapy and response prevention (EX/RP). We hypothesized that a patient׳s stage of change, initially and throughout treatment, would be associated with both treatment outcome and symptom severity. The URICA was administered to a sample of 424 patients admitted to a residential treatment program for OCD at admission and after 30 days of treatment. Y-BOCS was given at admission and discharge. Stage of change at admission did not predict outcome. However, Precontemplation at discharge was associated with shorter length of stay. Results and their implications will be presented along with a discussion of future directions.