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MONTREAL - Psychologists at Concordia University are developing a new therapy for the most common form of obsessive compulsive disorder - compulsive checking - and hope to enrol patients in a study by September.

It's estimated that more than 650,000 Canadians suffer from varying degrees of OCD. Compulsive checking - an endless cycle of checking and re-checking to make sure that the front door is locked, for example - affects nearly one in three people with OCD, followed by compulsive washing or cleaning.

Until now, the standard treatments for compulsive checkers have been anti-depressants and a British therapy developed in 1966 called exposure and response prevention. But both treatments have been problematic, said Adam Radomsky, an associate professor of psychology at Concordia.

"The anti-depressants have often been given at high doses, and we know that people tend not to prefer medications, as they have side effects," Radomsky explained.

Exposure and response prevention, or ERP, has been around since 1966, and involves repetitive exercises to get patients to face their fears. Not surprisingly, one in-two compulsive checkers won't even attempt ERP.

"In essence, the way I like to summarize ERP is you're asking your client to do the things they fear the most in the world and not to use the checking behaviour which they have found to be helpful to them," he said.

Radomsky and his colleagues are instead focusing on the thinking that drives compulsive checking rather than the actions. They are proposing a tailored form of cognitive behavioural therapy for compulsive checking.

As a clinical psychologist, Radomsky has come across patients who are so consumed by compulsive checking that they are unable to leave their homes. Others have been known to dislodge the door handles from their cars from endlessly checking to make sure the door is locked.

"Checking works very well in the short term at reducing your anxiety," he said. "Unfortunately, in the long run it actually contributes to the problem."

In fact, previous research has found that repetitive checking produces a loss of confidence in one's memory.

For the average person, checking one's passport on the way to the airport is a normal response. A compulsive checker, however, perceives irrational threats and struggles to cope by checking constantly. What's more, compulsive checkers know that they have a problem, Radomsky said.

The cognitive behavioural model that is being proposed involves 12 weeks of therapy. Among the therapeutic targets are restoring confidence in one's memory, reducing self-doubt and guilt, as well as exercises in "transferring responsibility."

Patients will be followed daily to track their progress while the psychologists assess the effectiveness of their therapeutic interventions.

"I actually think that we fail our clients with our (standard) treatments because they are too difficult," Radomsky said.

"So what we are trying to do is develop a treatment that will be just as effective but much more acceptable (to patients)."

                    Cheers ! HF&RV  - Les   ( Ok go back to the top & read again) - lol