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OCD CBT Duration — MRCPsych Paper B MCQ

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ModerateAnxiety & Stress-Related DisordersOCD CBT DurationMRCPsych Paper B

A 35-year-old man with obsessive-compulsive disorder has moderate functional impairment. After discussing the comparably effective initial treatment options, he chooses cognitive behavioural therapy including exposure and response prevention rather than an SSRI. According to NICE CG31, what level of therapist input defines the more intensive CBT intervention that should be offered?

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Correct answer: C — More than 10 therapist hours per patient

The correct answer is C. NICE defines more intensive CBT including ERP for an adult with OCD and moderate functional impairment as more than 10 therapist hours per patient. The patient should be offered a choice between this intervention and a course of an SSRI, as they appear comparably effective. By contrast, low-intensity psychological treatment involves up to 10 therapist hours and is primarily recommended initially for mild functional impairment or when the person prefers a low-intensity approach. Therefore, 4–6 hours and 8 hours fall within low-intensity treatment. NICE does not specify exactly 20 hours or at least 30 hours as the defining threshold. The recommendation concerns therapist input measured in hours, not a fixed number of sessions.

Reference: National Institute for Health and Care Excellence. Obsessive-compulsive disorder and body dysmorphic disorder: treatment (CG31), recommendation 1.5.1.3. Published 2005; last reviewed 11 July 2024. https://www.nice.org.uk/guidance/cg31/chapter/Recommendations