The Cognitive Behaviour Therapist (2015), vol. 8, e6, page 1 of 17
doi:10.1017/S1754470X15000100
ORIGINAL RESEARCH
‘Life just kind of sparkles’: clients’ experiences of being in
cognitive behavioural group therapy and its impact on
reducing shame in obsessive compulsive disorder
Melanie Spragg
*
and Sharon Cahill
University of East London, Stratford Campus, Water Lane, London, UK
Received 16 May 2014; Accepted 24 February 2015
Abstract. This study explored the personal accounts of service users relating to their
experiences of being in group cognitive behavioural therapy (GCBT) for obsessive
compulsive disorder (OCD). Eight participants were purposively selected from two
groups whose therapy had finished. These participants were interviewed, the data
transcribed verbatim and analysed using interpretative phenomenological analysis
(IPA). Five superordinate themes were generated: ‘Engagement in the group process’,
‘Normalizing’, ‘Courage to fight’, ‘Being my own therapist’ and ‘Restricted vs.
engagement with life’. The findings in this study have implications for theory in terms
of the relevance of shame-based appraisals in conceptualizations of OCD. Suggestions
for future groups include the importance of exploring the development of the problem
in the group setting and highlight an important role for the group in terms of increasing
motivation and preventing dropout. Directions for future research and implications for
theory are explored.
Key words: Group therapy, obsessive compulsive disorder, qualitative research
Introduction
Evidence for the effectiveness of group cognitive behavioural therapy (GCBT) for obsessive
compulsive disorder (OCD) is on the increase. Results from outcome research measuring
symptom reduction pre- and post-therapy (Anderson & Rees, 2007; Jaurrietta et al. 2008)
suggest that contemporary CBT for OCD can be beneficial for clients when carried out in
a group setting. Cognitive models of OCD (Salkovskis, 1989, 1998; Salkovskis et al. 2000)
argue that a specific appraisal concerning responsibility for harm distinguishes OCD from
other anxiety-based difficulties. In all current cognitive behavioural conceptualizations, the
emotional response in OCD has been associated with threat and danger (Clarke, 2005): the
role of guilt in OCD has also been highlighted (Veale, 2007). However, the significance of
shame defined as ‘acute arousal of fear of being exposed, scrutinized and judged negatively
by others’ (Gilbert & Trower, 1990) has been less explored in the CBT literature.
*
Author for correspondence: Dr M. Spragg, University of East London, Stratford Campus, Water Lane, London E15
4LZ, UK (m.spragg@uel.ac.uk).
© British Association for Behavioural and Cognitive Psychotherapies 2015