Treatment of a client with obsessive-compulsive disorder

A client with obsessive-compulsive disorder was handicapped by severe ritualizing behavior. Treatment tested the following hypotheses: that the behavioral techniques of exposure, response prevention, and modeling would reduce ritualizing in a client with obsessive-compulsive disorder, and that depression and anxiety would be reduced as ritualizing is reduced. Self-monitoring, the Spielberger State-Trait Anxiety Inventory, and the Beck Depression Inventory were used to test the hypotheses. Data were analyzed by the celeration line approach. Treatment intervened with all of the client's rituals; three were selected for measurement. After 8 weeks the target rituals and numerous others had been eliminated. Gains were stable at 3- and 6-month follow-up, validating the effectiveness of the treatment. Anxiety was not reduced, and depression was not a factor once behavioral treatment began. The success of this treatment approach demonstrates the value of using a single-system design to evaluate social work practice.