Brief Consultation to Families of Treatment Refusers with Symptoms of Obsessive Compulsive Disorder: Does It Impact Family Accommodation and Quality of Life?

Melanie M. VanDyke^1,2*, C. Alec Pollard^1,3, Jacob Harper², Kyle E. Conlon^1,4

¹Center for OCD and Anxiety-Related Disorders, Saint Louis Behavioral Medicine Institute, St. Louis, MO, USA.
²Department of Liberal Arts, St. Louis College of Pharmacy, St. Louis, MO, USA.
³Department of Family and Community Medicine, Saint Louis University, St. Louis, MO, USA.
⁴Currently at the Department of Psychology, Stephen F. Austin State University, Nacogdoches, TX, USA.

DOI: 10.4236/psych.2015.612152                

Abstract

Family members are often directly and significantly impacted by the restrictive demands of OCD, a frequently disabling disorder. Family accommodation behaviors (i.e., doing things for or because of the OCD sufferer that a person would not normally do) are associated with dysfunction, including poorer treatment responses in OCD sufferers and greater distress in family members. Although evidence suggests family-based intervention can reduce symptoms in OCD sufferers who participate in treatment, there is a lack of research documenting the impact of interventions designed for the families of OCD treatment refusers (TR). Brief Family Consultation (BFC) was developed by our clinical team to help families refocus their efforts on the things that they can realistically control and change (e.g., participation in compulsions). In this crossover study, twenty families related to an individual who exhibited OCD symptoms but had refused treatment were assigned to five phone sessions of either BFC or a psychoeducation condition. Compared to this credible, attention-placebo control group (Brief Educational Support; BES), BFC (but not BES) resulted in reductions in family accommodation behavior, yet neither BFC nor BES resulted in improved quality of life for family members of treatment refusers. BFC is one of the first interventions to be evaluated for its ability to help families when their loved ones with obsessive compulsive symptoms refuse treatment. This pilot study provides new insights for clinicians and researchers to better address the needs of these neglected families.

Keywords

OCD, Treatment Refusal, Family Therapy, Family Accommodations, Quality of Life

Conflicts of Interest

The authors declare no conflicts of interest.

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