Exposure and response prevention (ERP) is the gold standard therapy for people with obsessive compulsive disorder (OCD). But for some reason, it wasn’t effective for Anne and Andy Heller’s family member. So, the couple, who are members of McLean’s National Council and generous donors to OCD research at McLean, are pleased to be supporting a promising young researcher who is looking into why the therapy doesn’t work well for some patients.
“There are different ways to implement ERP,” explained the researcher, Jennie Kuckertz, PhD, a post-doctoral fellow at McLean’s OCD Institute (OCDI). “I’m interested in discovering the mechanisms at work in ERP. How can we look at the person in front of us and identify what approach to ERP would be most helpful?”
Support That Helps Launch Research Careers
Kuckertz is one of four talented investigators at the beginning of their careers whose research has been supported by the Hellers. The others are Martha Falkenstein, PhD, Jacob Nota, PhD, and Nathaniel Van Kirk, PhD.
Falkenstein uses machine learning, a technique that finds insights in large amounts of data, to improve therapy. Nota investigates how disrupted sleep cycles and low alertness affect the success of OCD treatment. And Van Kirk’s research tracks patients’ heart rates, movement, and other variables through wearable sensors to better understand how treatment is working.
“The Hellers have been truly instrumental in forwarding our research agenda,” said OCDI Program Director Diane Davey, RN, MBA. “These young investigators have gone on to obtain their own outside research grants, thanks to the work the Hellers supported.”
Jason Krompinger, PhD, the OCDI’s director of psychological services and clinical research, added that “the research they’ve enabled helps inform our clinical decision making, which in turn has improved the care we provide.”
OCD is characterized by recurring and unwanted thoughts, ideas, or sensations that drive the individual to perform repetitive actions to neutralize the fear and anxiety. The fears of patients treated at McLean have run the gamut, according to Krompinger: that their house will explode from an untended gas stove; that they’ve blasphemed and offended God; that they will become contaminated by touching surfaces.
The disorder is believed to affect about 3% of the population. McLean offers different levels of treatment—from residential to partial hospital to outpatient—for people of all ages, including a new satellite program in Houston, Texas.
Treatment That Exposes Patients to Triggers
Exposure and response prevention therapy encourages patients to do the things they fear—touching a public restroom toilet, uttering a curse word, holding a knife—then helps them refrain from the ritualized behavior. The person learns that it’s possible to endure the trigger without engaging in the compulsion. Ideally, the feeling of self-efficacy builds each time the behavior is avoided.
Kuckertz said her research is revealing that some patients may respond better to ERP if the therapist emphasizes that feeling of self-efficacy. “The therapist might need to spend more time before and after the exposure helping the person think about their ability to cope, what coping looks like for them, and areas where their reaction to the trigger didn’t match their expectation,” she explained.
The Hellers said that they’ve been impressed with McLean’s OCD research and treatment programs and the constant interplay between the two. “As in any field, young minds offer new and creative ways to approach a subject, bringing creative energy to their area of expertise,” said Anne. “They can potentially challenge antiquated concepts and offer fresh perspectives and innovation. It’s been exciting to witness Jennie’s accolades and awards during her short time at McLean.”
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