Title: Improving and maintaining mental health: Development of a blended intervention for relapse prevention in Obsessive Compulsive Disorder (OCD)
Funder: The Academy of Medical Sciences

Abstract: Following the MRC guidelines for complex intervention development, the aims of the proposed research are: 1)Develop a blended relapse prevention intervention for Obsessive Compulsive Disorder (OCD) using a co-production model, with people who have OCD. (Blended interventions combine the strengths of face-to-face and digital approaches). 2)Conduct a feasibility pilot RCT with OCD patients (N = 70) to evaluate feasibility, acceptability and user experience of the intervention. Results of this study will provide the necessary foundation to secure a larger grant, to conduct a fully-powered multi-centre RCT. The impact of such research will be on the NICE guidelines for OCD, intention is for relapse prevention to be incorporated into standard care protocols. OCD is the sixth largest contributor to “non-fatal health loss” globally, affecting 750,000 people in the UK and costing the NHS £9.8 billion per year. Those who suffer from OCD spend on average 10 waking hours each day in the grip of relentless and debilitating intrusive thoughts and compulsive behaviours. Further compounding the issue, crippling symptoms coupled with the associated shame and stigma, lead to social isolation and significant delays in seeking help. The short-term efficacy of Cognitive Behavioural Therapy (CBT) for OCD is well established. However, relapse rates are high. Up to 60% of adults will relapse after CBT, in most cases (85%) within the 12-months following completion of therapy. Despite the high personal, societal and economic cost, no therapeutic intervention exists to address this problem. The aim of my project is to address this.

Lay abstract: “I had a brilliant therapist, and I made a lot of progress…but, I went from having quite a lot of support, to none…” “The trouble is, NICE guidelines should say you should get follow up, and I think that would have helped […] Wish there’d been a resource…so you can catch it, if you’re starting to relapse” “It’s [relapse] just devastating, because you’re thinking, “Am I going to go to back to ground zero and have to start all over again?” “Am I going to go back to having no life whatsoever?”. These quotes are from people with Obsessive Compulsive Disorder (OCD) that had a talking therapy, called CBT. It helped them recover, but after it finished, their OCD returned. With physical conditions, follow up is a standard part of care, but this is not the case for OCD. However, research shows that up to 60% of people with OCD will experience relapse after CBT. We know that 85% of relapses occur in the 12 months after treatment. I want to change standard care for OCD by developing and testing a relapse prevention programme, aimed to become a part of standard care. This will be done in collaboration with people who have OCD. Together we will develop a 10-session group programme, (delivered online) and a digital app. The app can be used daily and continue to be used after the group finishes. The aim is to support people to keep gains made in therapy, in order to stay well long-term.

Research activity codes: 5.6 PSYCHOLOGICAL AND BEHAVIOURAL
Health categories: MENTAL HEALTH