e as effective as therapist-controlled exposure in vivo, in spite of the fact that in the latter condition each treatment session lasted twice as long as in the former condition. (p. 491)
Regarding the question of how valid or how much confidence to place in the conclusions of the study, it must be stated that a number of problematic methods suggest that conclusions should be considered, at best, tentative. Methodological problems included the facts that: (1) the sample was extremely small with no more than six to seven patients per group; and (2) the study did not control for possible intervening or moderating factors such as patients' age, gender, or length of complaint.
Three single-subject studies of behavioral treatment (prevention of ritualistic behavior following in vivo exposure) of OCD were conducted by Turner, Hersen, Bellack and Wells (1977). Unlike the Emmelkamp and Kraanen (1977) study, the measure of ritualistic behavior in Turner et. al's research was through direct observation and not through self-report responses to a questionnaire.
Taken together, the three experiments assessed whether simple ritualistic response prevention treatment was improved by the addition of flooding strategies and/or medication. Based on findings, flooding and medication were judged as contributing no gains to the reduction of ritualistic behavior. However, the presence of other symptomology (e.g., depression, interpersonal problems) following treatment lead Turner et. al (1979) to conclude that a more holistic treatment approach was required for a complete remediation of OCD.
The conclusion that a more holistic treatment model be used for OCD seems justified given the findings of the study and the fact that the definitional criteria for OCD define it as a cognitive-behavioral problem and not just a strictly behavioral disorder. However, to conclude that medication added nothing when the research used only one patient and o...