Danger Ideation Reduction Therapy (DIRT) for Atypical Obsessive—Compulsive Disorder: A Case Study

Abstract

This paper describes the application of danger ideation reduction therapy (DIRT) to a case of atypical obsessive—compulsive disorder (OCD) with prominent magical ideation. Treatment consisted of eight weekly sessions. It was cognitive in nature, did not include any exposure or response prevention, and was aimed solely at reducing threat expectancy. The treatment components were adapted from the original DIRT package for compulsive washing, and comprised attentional focusing, corrective information, cognitive restructuring and the probability of catastrophe estimation task. At posttreatment, the subject demonstrated normal functioning on all assessment measures, and met Jacobson and Truax's criteria for ‘recovery’ on the MOCI, OCI-R, DASS depression scale and DASS stress scale. The findings provide preliminary support for the effectiveness of DIRT in individuals with atypical OCD symptoms characterised by magical ideation. Implications of these findings are discussed.