Danger Ideation Reduction Therapy (DIRT ) for Obsessive Compulsive Checkers : A Comprehensive Guide to Treatment

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.