Obsessive Compulsive Disorder: Presentation of a Clinical Case and Treatment using Acceptance and Commitment Therapy (ACT) Processes
Rossella Cirrone, Roberto Anchisi
This paper describes a case of Obsessive Compulsive Disorder (OCD) in a 39-year-old woman affected by hearing impairment and paraphilia. Treatment was particularly challenging due to the nature of the disorder and the difficulties in conducting the clinical interviews given the deafness of the patient. The case conceptualisation, based on acceptance and commitment therapy (ACT; Hayes & Hofmann, 2020) processes, enabled the verbal relational framing determining the reinforcement of verbal rules centred on the control of internal experience to be solved. The principles of relational frame theory (RFT; Törneke, 2010) provided a clear understanding of the connections that determined self-conceptualisation with the manifested paraphiliac compulsions. The therapy process was conducted from a functional contextualistic perspective, according to the OCD model developed by Twohig, Moran and Hayes (2016), in which the cognitive fusion and experiential avoidance processes determine a relevant restriction on values and behaviour. Therefore, the treatment focused on planning exposure contexts to expand the behavioural repertoire with value-based actions, the gradual reduction of obsessions and the forsaking of paraphiliac habits.
Keywords
Obsessive Compulsive Disorder, Paraphilia, Relational frame theory, Acceptance and commitment therapy, Sensory disability.
