Cognitive-Behavioural Therapy vs. Mindfulness-Based Cognitive Therapy for Obsessive-Compulsive Disorder: Effectiveness and Treatment Mechanisms

ObjectivePreliminary clinical research supports the potential effectiveness of mindfulness-based interventions for obsessive-compulsive disorder (OCD). The current naturalistic community treatment study aimed to assess the comparative effectiveness of mindfulness-based cognitive therapy (MBCT) and cognitive behavioural therapy (CBT) and to explore whether the hypothesized treatment mechanisms in CBT and MBCT relating to improved clinical outcomes are distinct or overlap.MethodsClinical participants (N = 245) in a university-affiliated specialty OCD assessment and treatment centre, with primary DSM-5 diagnosed OCD experiencing clinically significant obsessive-compulsive symptoms completed structured group interventions for CBT or MBCT and reported symptom, cognitive, and mindfulness ratings across treatment.ResultsThe results indicated that both CBT (d = 1.64) and MBCT (d = 1.34) treatments produced clinically and statistically large and equivalent effects on the primary measure of obsessive-compulsive symptom severity. In the examination of putative treatment mechanisms, model fit was acceptable, and results supported the hypothesized cross-lagged associations between change in obsessive beliefs and symptom reduction in CBT, and cross-lagged associations between change in self-compassion and symptom reduction in MBCT. ConclusionsThese results provide preliminary evidence for the effectiveness of mindfulness-based interventions in OCD and point to the possibility of specific treatment mechanisms distinct from CBT, although this will require further examination in randomized controlled trials.