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Danger Ideation Reduction Therapy (Dirt ) for Obsessive Compulsive Checkers

DIRT for Checkers is a unique new evidence-based treatment program designed to specifically reduce expectancies of danger or threat in those with Obsessive Compulsive Disorder (OCD) with predominant checking concerns. Unlike many traditional OCD treatments, DIRT is based on the rationale that the therapist should provide as much factual information as possible to decrease the expectancy that harmful events such as the fear of fire, damage, theft, harm to others and other physical losses will follow any failure to check and thus reduce the high dropout rate seen in conventional OCD exposure and response prevention programs. DIRT consists of six discrete treatment components aimed at reducing the number of intrusive thoughts experienced and concurrently allowing the client to successfully change the remaining thoughts and beliefs. The treatment includes attentional focusing, cognitive restructuring, double-checking experiments, corrective information, filmed interviews, probability of catastrophe task. This manual includes a resource CD with over 100 patient handouts including information sheets on a range of security and safety concerns and a DVD of filmed occupational interviews about risk assessment covering 7 different occupations. DIRT has been shown to be a highly successful treatment package for OCD, able to shift even the most intractable of cases. Randomised control studies have established that DIRT represents a viable alternative to the standard behavioural approach. In addition, DIRT appears to have several potential advantages over behavioural and pharmacological treatments: * Unlike in an Exposure and Response Prevention (ERP) program, clients who undergo the DIRT regime are not asked to confront anxiety-provoking (feared) stimuli. This is particularly important since many sufferers either refuse exposure treatment or drop out before completion because of its anxiety-provoking effects.* Unlike medication used in the treatment of OCD, DIRT achieves its success without the complication of physical side effects.* DIRT is a highly structured treatment package involving films, information sheets and worksheets which are relatively inexpensive to package and administer.* DIRT appears to require relatively few sessions for its therapeutic effect. Substantial reductions in OCD symptomatology have been achieved in as few as six clinical hours.* DIRT may prove beneficial for intractable patients who have failed with standard treatments, and for those who exhibit poor insight.
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About the Author

Lisa Vaccaro is currently a candidate for a Doctor of Philosophy (PhD) at the University of Sydney. She completed undergraduate and began postgraduate studies at Macquarie University - awarded a Bachelor of Arts (Psychology) in 1998 and a Postgraduate Diploma in Psychology in 1999. Under direction of the late Professor of Surgery - Christopher J. Martin - Lisa was employed to assist the development and conducting of world-class clinical research trials.Mairwen Jones is currently Senior Lecturer in Psychology in the Faculty of Health Sciences, The University of Sydney.Ross G. Menzies has been providing CBT for OCD, phobias, anxiety and depression in the inner-west of Sydney for over 15 years. He is currently Associate Professor of Psychology in the Discipline of Behavioural and Community Health Sciences at the University of Sydney.Tamsen St Clare obtained her honours degree in Psychology and her Masters degree in Clinical Psychology from the University of Sydney. She is currently working as a Clinical Psychologist in private practice. She is formerly Senior Clinical Psychologist and Head of the Sydney West Area Health Service's Anxiety Treatment and Research Unit, and Clinical Director of the University of Sydney Anxiety Disorders Clinic.

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