My son Dan suffered from obsessive-compulsive disorder so severe he could not even eat. He spent nine weeks at an intensive world-renowned residential program where he learned techniques through the use of exposure and response prevention (ERP) therapy. These skills have allowed him to live a happy and productive life.
Well, at least I thought it was an intensive program.
At Haukeland University Hospital in Bergen, Norway, there is a treatment program for OCD that is truly intensive. And short. Four full days.
There are many people who spend years of their lives suffering with OCD; it can be a cruel, insidious disorder. How much can four full days of intensive therapy help them?
Apparently, a lot.
More than 1,200 people have received the Bergen four-day treatment for OCD which is a concentrated form of exposure therapy designed by two Norwegian psychologists, Gerd Kvale and Bjarne Hansen. The results have been impressive and the program has gained international attention for its effectiveness and efficiency. In fact, the psychologists were named by Time as two of 2018’s 50 most influential people in healthcare.
Avital Falk, a clinical psychologist who directs an intensive treatment program for OCD and anxiety at Weill Cornell Medicine and New York Presbyterian says:
“It’s amazing that you can so get much done in such a small amount of time. OCD treatment regimens typically involve weekly hour-long sessions spread out across several months, but more clinicians are adopting concentrated therapy. Intensive treatment in general has been getting a lot more attention in different formats that can be anywhere from three hours a week. Ten to 12 hours a week, all the way to the Bergen method, which does everything in four days.”
In June 2012 the first group of patients were tested and the results were as expected — immense improvements in the participants’ OCD.
The Bergen method works in three stages:
On day one, therapists provide patients with information about OCD and help them prepare for the exposure tasks they will engage in over the next two days. During the exposure portion, people face their fears head-on. For example, if someone is afraid of becoming contaminated, they would choose an object or surface that might trigger their anxiety and then force themselves to touch it. Kvale explains:
“We encourage patients to pay attention to the moments when they feel the urge to start taking control to reduce anxiety or discomfort. And to use these as turning points for change.”
The next two days can be best described as a single prolonged therapy session. Included with ERP therapy is the use of the LET- technique, which is a method of encouraging those with OCD to focus specifically on anxiety-eliciting moments. LET stands for LEan into The anxiety and forms the core foundation of the Bergen treatment. The format of the treatment is unique in that a group of three to six therapists work as a team with an equal number of patients. Kvale believes this setup is important because it provides tailored care for each individual while also letting patients observe others going through the same process of change.
The third day is set aside for discussion and planning how to maintain the gains made during therapy.
In August 2018, results from a long-term analysis of the treatment’s effects were published. It was reported that 56 of 77 patients remained in remission four years after treatment, and 41 of the 56 had fully recovered. More details regarding the results can be found here.
There are already plans to bring this treatment plan to other countries, including the United States. While promising, there are lots of unanswered questions. Is this program effective for those whose compulsions are mostly mental? Can it be helpful to those who deal with recovery avoidance? The list goes on.
As treatments for OCD evolve, one thing continues to be clear. More of the right kind of therapy is always a good thing.
Hansen B, Hagen K, Öst L-G, Solem S, Kvale G. The Bergen 4-day OCD treatment delivered in a group setting: 12-month follow-up. Front Psychol. 2018;9:369.
Oaklander, M. (N.D.). Bjarne Hansen and Gerd Kvale: Speeding Up Therapy. TIME. Retrieved from http://time.com/collection/health-care-50/5425089/gerd-kvale-and-bjarne-hansen/
Kwon, D. (2018, November 29). 4 days of intensive therapy can reverse OCD for years. Scientific American. Retrieved from https://www.scientificamerican.com/article/4-days-of-intensive-therapy-can-reverse-ocd-for-years/
Hansen, B., Kvale, G., Hagen, K., Havnen, A., & (2018). The Bergen 4-day treatment for OCD: four years follow-up of concentrated ERP in a clinical mental health setting, Cognitive Behaviour Therapy,