Patient adherence to cognitive-behavioral therapy predicts long-term outcome in obsessive-compulsive disorder.

To the Editor: Our prior research1 demonstrated that patient adherence to homework during cognitive-behavioral therapy (CBT) strongly predicts acute outcome for patients with obsessive-compulsive disorder (OCD). To examine whether homework adherence also predicts outcome at 6-month followup, we capitalized on data from a clinical trial2 that provided CBT consisting of exposure and ritual prevention (EX/RP) to 30 adults with OCD, measured homework adherence during acute treatment using a reliable and validated scale, and reevaluated severity of OCD 6 months later.