© 2003 Oxford University Press
Family Responses and Multifamily Behavioral Treatment for Obsessive-Compulsive Disorder
From the Angell Street Wellness Collaborative and Brown University (Van Noppen) and the Boston University School of Social Work (Steketee).
Contact author: Barbara Van Noppen, MSW, LICSW, Angell Street Wellness Collaborative, 469 Angell Street, Providence, RI 02906. E-mail: Babsvn{at}cox.net.
Family responses to obsessive-compulsive disorder (OCD) that have relevance to behavioral treatments for adults with this disorder include family accommodation, family members' expression of emotion (EE) toward patients, and the effects of including family members in treatment. Family accommodation to OCD symptoms has been linked to greater severity of symptoms and poorer family mental health. Components of EE, including hostility and perceived criticism, have proved predictive of poorer outcome following behavioral treatment, but nonhostile criticism appears to improve outcomes. A model of multifamily behavioral treatment, in which relatives and patients are trained in exposure and blocking of rituals, as well as behavioral contracting to improve communication, is presented and illustrated in case examples. [Brief Treatment and Crisis Intervention 3:231247 (2003)]
KEY WORDS: expressed emotion, EE, family accommodation, exposure and response prevention