© 2002 Oxford University Press
Multifamily Behavioral Treatment (MFBT) for Obsessive Compulsive Disorder (OCD): A Step-by-Step Model
From the Brown University School of Medicine.
Contact author: Barbara Van Noppen, MSW, LICSW, Research Associate, Brown University School of Medicine, 469 Angell Street, Providence, RI 02906. E-mail: Barbara_Van_Noppen{at}brown.edu
Obsessive compulsive disorder (OCD) can be a severe, chronic anxiety disorder for which pharmacotherapy and behavioral therapy have both proven effective for approximately 75% of such patients. However, the majority of patients experience a recurrence of symptoms when medications are stopped and 25% to 35% of those treated with behavior therapy fail to benefit or relapse during follow-up. OCD rarely leaves the family system unaffected. Family research indicates that close to 90% of family members accommodate to rituals by participating directly in compulsions, facilitating avoidance, and modifying personal and family routines. These fall-out effects of OCD can inhibit behavioral treatment if not addressed in a family context. Multifamily groups have been useful in treating both medical and psychiatric patients. In particular, long-term outcome in preventing relapse for schizophrenic patients has proven to improve after a multifamily approach. Pilot data of multifamily treatment for OCD demonstrates that this modality is as effective as group behavioral therapy for patients alone, and comparable to individual behavioral therapy. This article describes in detail an 18-session multifamily behavioral family treatment program for OCD that holds promise for improving symptoms while activating family members to participate in behavioral treatment to improve outcome by understanding the disorder, managing OC symptoms more effectively, and improving the quality of life for all family members.
KEY WORDS: obsessive compulsive disorder, anxiety disorder, multifamily groups, behavior therapy, group therapy, family treatment
