2003 OCF Grant

Multi-site study of CBT treatment failures

Sabine Wilhelm, PhD & Gail Steketee, PhD

Harvard Medical School (Cambridge, MA); Boston University (Boston, MA)

Award Amount: $30,000

Cognitive behavioral therapies (CBT) are a group of evidence-based treatments for OCD, including cognitive therapy, behavioral therapy, exposure and response prevention therapy (ERP). Despite their overall efficacy, some people with OCD do not respond to CBT and do not see their symptoms lessen or resolve.

The team led by Drs. Wilhelm and Steketee aimed to answer the question of why some patients with OCD do not respond to cognitive therapy (CT) by conducting 22 sessions of CT with specific strategies for certain OCD subtypes on 39 participants with OCD. While this treatment course significantly decreased OCD symptoms in the sample, higher self-perceived OCD symptoms upon intake were associated with worse outcomes after treatment. Greater improvement was associated with the presence of sexual obsessions, strong motivation to engage in treatment, and comorbidity with major depressive and anxiety disorders. An increase in OCD symptoms one year following the CT was predicted by high personality disorder scores, such as schizotypal personality disorder. 


Resulting Publications:

* Steketee, G., Siev, J., Fama, J.M., Keshaviah, A., Chosak, A., & Wilhelm, S. (2011). Predictors of treatment outcome in modular cognitive therapy for obsessive compulsive disorder. Depression and Anxiety, 28(4), 333-341. doi:10.1002/da.20785