Obsesif Kompulsif Bozuklukta Kabul ve Kararlılık Terapisi Uygulamaları

Öz

Obsesif kompulsif bozukluk (OKB), müdahaleci ve rahatsız edici düşünce içeriklerinin etkisini ve anksiyete miktarını azaltmak amacıyla zaman alıcı zihinsel veya davranışsal aktivitede bulunma ile karakterize, belirgin sıkıntıya yol açan ruhsal bir bozukluktur. OKB’ye anksiyete bozuklukları, depresyon, intihar düşünceleri eşlik etmekle beraber çalışma ve sosyal hayatta önemli işlevsel bozulmalar ve yaşam kalitesinde büyük düşüşler görülmektedir. OKBtedavisinde sıklıkla seçici serotonin geri alım inhibitörleri (SSRI) ve bilişsel davranışçı terapi (BDT) müdahaleleri kullanılmakla beraber üçüncü nesil terapiler arasında yer alan Kabul ve Kararlılık Terapisi (KKT) uygulamalarının OKB semptomlarını azaltmada etkili olabileceğine yönelik umut veren sonuçlar görülmektedir. KKT, semptomları doğrudan ortadan kaldırmak yerine, psikolojik esnekliği artırmayı hedefler. Kabul, bilişsel ayrışma, anda kalma, bağlamsal benlik, değerlerle temas ve değer odaklı davranışlarda kararlılık olmak üzere altı temel süreç üzerinden ilerler. OKB bağlamında, KKT bireylere rahatsız edici düşünce ve duyguları kontrol etmekten vazgeçip onları kabul etmeyi, bu içsel yaşantılara rağmen kişisel değerleri doğrultusunda anlamlı bir yaşam sürdürmeyi öğretir. Yapılan çalışmalar, KKT'nin OKB semptomlarında BDT ve maruz bırakma terapisi ile karşılaştırılabilir düzeyde azalma sağladığını, özellikle SSRI tedavisine ek olarak uygulandığında tedavi etkinliğini daha da artırdığını göstermektedir. Sonuç olarak, KKT OKB tedavisi için etkili bir seçenek olarak öne çıkmakta, ancak daha fazla randomize kontrollü çalışmaya ihtiyaç duyulmaktadır.

Anahtar Kelimeler

• Obsesif kompulsif bozukluk
• kabul ve kararlılık terapisi
• tedavi

Implementation of Acceptance and Commitment Therapy in Obsessive Compulsive Disorder

Abstract

Obsessive-Compulsive Disorder (OCD) is a mental disorder characterized by engaging in time-consuming mental or behavioral activities to reduce the impact and anxiety caused by intrusive and invasive thought content, leading to significant distress. OCD is often accompanied by anxiety disorders, depression, and suicidal thoughts, resulting in substantial functional impairments in work and social life, as well as a significant decline in quality of life. In the treatment of OCD, selective serotonin reuptake inhibitors (SSRIs) and cognitive-behavioral therapy (CBT) are commonly used. However, promising results suggest that Acceptance and Commitment Therapy (ACT), a third-generation therapy, may be effective in reducing OCD symptoms. Unlike directly eliminating symptoms, ACT aims to increase psychological flexibility. It progresses through six core processes: acceptance, cognitive defusion, being present, contextual self, contact with values, and commitment to value-driven behaviors. In the context of OCD, ACT teaches individuals to let go of controlling distressing thoughts and feelings, accept them, and pursue a meaningful life aligned with personal values despite these internal experiences. Studies indicate that ACT achieves reductions in OCD symptoms comparable to CBT and exposure therapy, particularly enhancing treatment efficacy when combined with SSRIs. In conclusion, ACT emerges as an effective option for OCD treatment, though further randomized controlled trials are needed.

Keywords

• Obsessive compulsive disorder
• acceptance and commitment therapy
• treatment

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