Home-Based Assessment and Treatment of Obsessive-Compulsive Disorder Symptoms to Reduce Unnecessary Emergency Room Usage in an Older Adult
Older adults with obsessive-compulsive disorder (OCD) may benefit from cognitive-behavioral therapy (CBT), but the disorder has been understudied in this population (Calamari, Pontarelli, Armstrong, & Salstrom, 2012; Grenier, Préville, Boyer, & O'Connor, 2009). This article presents a course of Exposure and Response Prevention (ERP) for an older White male veteran of WWII who had been a frequent utilizer of the emergency room for maladies that could be treated in the outpatient setting. The course of treatment for OCD comprised 14 sessions and was delivered in the veteran's home as a part of his care in the Veteran Affairs (VA) home-based primary care (HBPC) service. Adaptations were made to accommodate age-related cognitive deficits, treatment barriers related to mental health care access, stigma, safety concerns, and misperceptions regarding OCD and its treatment. Following ERP, significant reduction in self-reported distress related to OCD was observed. Recommendations for utilizing ERP within a HBPC context are offered.