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Clinical Handbook of Obsessive-Compulsive and Related Disorders pp 385–397Cite as

Treatment of an Adult with Obsessive-Compulsive Disorder with Limited Treatment Motivation

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Abstract

Despite experiencing significant and impairing symptoms, some individuals with obsessive-compulsive disorder (OCD) demonstrate limited motivation for treatment, which can interfere with their adherence to an effective treatment, such as exposure and ritual prevention (E/RP). This chapter addresses the issue of motivation in treatment-seeking OCD patients and reviews approaches to enhance motivation, with a particular focus on motivational interviewing (MI). Using the case history of an adult with OCD and limited motivation who was treated in our clinic, we illustrate several strategies to enhance treatment participation derived from MI. The goal of this approach is to resolve ambivalence in favor of a patient’s intrinsic motivation towards positive change. Specific MI-congruent approaches utilized in this case include strategies for eliciting change talk and defusing discord. As illustrated in the chapter, these efforts succeeded in enhancing the patient’s willingness to fully participate in treatment, resulting in a significant reduction in his OCD symptoms. We conclude by reviewing important practice points.

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Author information

Authors and Affiliations

  1. Anxiety Disorders Clinic and the Center for OCD and Related Disorders, New York State Psychiatric Institute, 1051 Riverside Drive, Unit 69, 10032, New York, USA

    Michael G. Wheaton PhD & H. Blair Simpson MD, PhD

  2. Department of Psychiatry, Columbia University Medical Center, Columbia University, New York, NY, USA

    Anthony C. Puliafico PhD & H. Blair Simpson MD, PhD

  3. Departments of Psychology and Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA

    Allan Zuckoff PhD

Authors
  1. Michael G. Wheaton PhD
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  2. Anthony C. Puliafico PhD
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  3. Allan Zuckoff PhD
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  4. H. Blair Simpson MD, PhD
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Corresponding author

Correspondence to H. Blair Simpson MD, PhD .

Editor information

Editors and Affiliations

  1. Department of Pediatrics, Health Policy & Management, Psychiatry & Behavioral Neurosciences, and Psychology, University of South Florida, St. Petersburg, Florida, USA

    Eric A. Storch

  2. Departments of Pediatrics, Psychiatry and Psychology, University of South Florida, Tampa, Florida, USA

    Adam B. Lewin

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Wheaton, M., Puliafico, A., Zuckoff, A., Simpson, H. (2016). Treatment of an Adult with Obsessive-Compulsive Disorder with Limited Treatment Motivation. In: Storch, E., Lewin, A. (eds) Clinical Handbook of Obsessive-Compulsive and Related Disorders. Springer, Cham. https://doi.org/10.1007/978-3-319-17139-5_26

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