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In the domain of clinical psychology, obsessive-compulsive disorder (OCD) is recognized as one of the most challenging psychological conditions to treat, particularly due to its incapacitating effect on the patient, their family and quality of life (Fairfax, Easey, Fletcher, & Barfield, 2014). This paper employs a case study approach to demonstrate how the mindfulness-based therapy can be effective in treating Hector’s OCD as described in the case scenario.
Mindfulness has been described in the literature as a form of insight mediation which relies on paying attention to current psychosocial and mental challenges in a focused and non-judgmental way with the view to nurturing superior awareness, clarity, and acceptance of present-moment reality (Fairfax et al., 2014). The rationale for selecting mindfulness is based on the fact that it can assist the patient in the case study to not only control his obsessions and ‘hot thoughts’ by bringing his attention under control, but also to severe the link associated with conditioned behavior and automatic thoughts (Wilkinson-Tough, Bocci, Thorne, & Herlihy, 2010). The rationale is also nested on the belief that the intervention will help the patient to learn a different way to relate to thoughts, not mentioning that it will facilitate discussion of the meta-cognitive process through experiential intervention (Fairfax, 2008).
The intervention, which is based on the cognitive behavior therapy (CBT), should run for at least 14 weeks as stakeholders engage Hector in the hope of assisting him to develop the capacity to tolerate the anxiety and resist the associated compulsive behaviors. The first three weeks should be devoted to assisting Hector to understand and challenge the various intrusive thoughts demonstrated in the case study, while the following two weeks should be dedicated to helping him manage mood. It is important to introduce the patient to the mindfulness intervention as early as possible by inviting him to take part in a 5-minute mindfulness-of-breath exercise in order to note particular reflections about the nature of his thoughts, control of attention and awareness of state in general (Fairfax, 2008). The patient should be encouraged to nurture superior awareness, clarity, and acceptance of present-moment reality through taking part in different mindfulness exercises that incorporate various techniques, not mentioning that feedback should be given by the professionals based on arising experiences. These exercises and reflections should run the full course of the program. Such routine engagements (e.g., encouraging the patient to undertake ‘mindful’ hand washing) should assist Hector to acknowledge the presence of intrusive thoughts and feelings and, in the process, help him develop mechanisms to resist compulsive thoughts, control distressing feelings, and complete the goal (Fairfax, 2008; Wilkinson-Tough et al., 2010).
The mindfulness intervention should involve Hector (the sufferer), family members, an experienced counseling psychologist, a community psychiatric nurse, as well as one or two support workers. It is important for the professionals to demonstrate adequate experience of mindfulness practice as well as cognitive behavior therapy for OCD (Fairfax et al., 2014).
Setting for Intervention and Targeted Area
The intervention can be delivered individually or via a group of persons with OCD; however, it is important to set it in home or community-based contexts to ensure participation of family members. Owing to the fact that the mindfulness approach is firmly embedded in CBT, it can be argued that psychological and social factors will be targeted in the process of assisting Hector to control his obsessions by bringing his attention under control. Here, the basic premise is that social factors can be used to shift the patients thought system and predisposition.
Drawing from this discussion, it is evident that the mindfulness therapy represents a step in the right direction in terms of managing incidences of OCD. However, more needs to be done to ensure that the intervention can be used in combination with other treatment and management strategies for successful outcomes.
Fairfax, H. (2008). The use of mindfulness in obsessive compulsive disorder: Suggestions for its application and integration in existing treatment. Clinical Psychology & Psychotherapy, 15(1), 53-59.
Fairfax, N., Easey, K., Fletcher, S., & Barfield, J. (2014). Does mindfulness help in the treatment of obsessive compulsive disorder (OCD)? An audit of client experience of an OCD group. Counseling Psychology Review, 29(3), 17-27.
Wilkinson-Tough, M., Bocci, L., Thorne, K., & Herlihy, J. (2010). Is mindfulness-based therapy an effective intervention for obsessive-intrusive thoughts: A case series. Clinical Psychology and Psychotherapy, 17(3), 250-268.