Mindfulness-based exposure and response prevention for obsessive compulsive disorder: Findings from a pilot randomised controlled trial

Clara Strauss, Laura Lea, Mark Hayward, Elizabeth Forrester, Tamara Leeuwerik, Anna-Marie Jones, Claire Rosten

Research output: Contribution to journalArticle


Background Only about half of people with obsessive compulsive disorder (OCD) show clinically significant improvement following the recommended therapy, exposure and response prevention (ERP), partly due to poor therapy acceptability. A mindfulness-based approach to ERP (MB-ERP) has the potential to improve acceptability and outcomes. Methods This was an internal pilot randomised controlled trial (RCT) of group MB-ERP compared to group ERP. 37 participants meeting DSM-IV OCD criteria were randomly allocated to MB-ERP or ERP. Results Both groups improved in OCD symptom severity. However, MB-ERP did not lead to clinically important improvements in OCD symptom severity at post-intervention compared to ERP − the minimum clinically important difference was not contained in the 95% confidence intervals. There were negligible between-group differences in engagement and MB-ERP did not appear to have broader benefits compared to ERP on depression, wellbeing or OCD-related beliefs. Conversely, MB-ERP led to medium/medium-large improvements in mindfulness compared to ERP. Conclusions MB-ERP is unlikely to lead to clinically meaningful improvements in OCD symptom severity compared to ERP alone. We underline the importance of adhering to treatment guidelines recommending ERP for OCD. Insufficient attention may have been given to mindfulness practice/discussion in MB-ERP and further research is recommended to explore this possibility.
Original languageEnglish
Pages (from-to)39-47
JournalJournal of Anxiety Disorders
Publication statusPublished - 30 Apr 2018


Bibliographical note

Under a Creative Commons Attribution 4.0 International (CC BY 4.0)


  • OCD
  • mindfulness
  • ERP
  • exposure and response prevention
  • cognitive therapy
  • MBCT

Cite this