Throw away and pull towards: A new way to challenge OCD related cognitions using the GGRO mobile application training platform.
Authors: M. Roncero, B. Pascual, S. Arnáez, M. Giraldo-O’Meara, G. García-Soriano, A. Belloch, and G. Doron.
According to cognitive models of OCD, obsessive compulsive symptoms result from catastrophic misinterpretations of commonly occurring intrusive thoughts, images and urges and the use of counterproductive strategies used to manage them. Maladaptive beliefs such as inflated responsibility/threat, importance and control of thoughts, perfectionism and intolerance for uncertainty increase the likelihood of such negative interpretations of intrusive experience. Indeed, traditional cognitive behavioral therapy (CBT) includes a variety of intervention to challenge maladaptive beliefs including behavioral experiments and cognitive reconstruction. Consistent with a growing body of literature supporting the usefulness of mobile based technologies in fostering cognitive behavior change, the present study assessed the effectiveness of a novel cognitive training exercise designed to challenge OCD related cognitive beliefs. This mobile technology (application) based training exercise consists of users having to pull statements challenging OCD-related beliefs towards themselves (downwards) and to throw away (push upwards) contra-productive self-statements Method: 36 third year BA students started the trial. Twenty completed both pre and post measures of OCD symptoms (OCI-R; Foa et al., 2002), ROCD (ROCI & PROCSI; Doron et al., 2012a, 2012b), OCD related beliefs (OBQ; Moulding et al., 2011) and mood (Antony et al., 1998). Participants were instructed to complete two minutes of daily training (3 training levels) for a period of 15 days. Results: No significant differences were found between completers and no-completers on demographic and symptom related measures at Time 1. Repeated-measures ANOVA of the 20 completers showed a significant reductions on all OCD symptoms measures and on OCD-beliefs. No significant reduction was found in depression symptoms. Discussion: This innovative mobile technology based training exercise may be useful in reducing OCD-related beliefs levels and associated symptoms. The use of this and similar mobile training platforms holds promise for low intensity psychological treatments recommended by NICE (2005), and may be effective as prevention tool for those people at risk of suffering OCD. Limitation: This is an open trial with relatively small student sample.
Does GGRO and with relationships doubts and preoccupations: An initial examination.
We thank all those participating in our pilot study of GGRO! below are the results of the study.
Background: Previous research has linked relationship-related anxieties, doubts and preoccupations (i.e., relationship obsessive compulsive disorder symptoms; ROCD) with reduced functioning, decreased relational and sexual functioning and lower mood. As knowledge of ROCD is emerging, individuals with such symptoms may be frequently misdiagnosed leading to reduced accessibility to adequate treatment. A growing body of literature has supported the usefulness of mobile technology in increasing accessibility to mental health knowledge and in fostering mental health or behavior change. In the present study, we examined associations between relationship related anxieties, doubts and preoccupations (i.e., ROCD symptoms) and the pattern of use of a mobile application named GGRO. This mobile application was designed to challenge maladaptive beliefs related to relationship difficulties. GGRO encourages two minutes of daily training (3 levels a day) over a period of at least 15 days.
Method. Fifty-one users of GGRO responded to a short survey pertaining to application use, satisfaction and relationship-related anxieties and preoccupations.
Results. The number of sessions ranged from 1 to 100 with forty-five participants reporting using GGRO five times or more. Medium-size statistically significant correlations were found between reported number of sessions of GGRO users (i.e., in participants that used GGRO more than 5 times) and relationship-related anxieties and preoccupations (Spearman’s rho r=-.35) suggesting greater number of sessions was related to less such relationship difficulties reported. Similarly, the higher the level participants reported reaching on GGRO (maximum being 45), the less relationship-related anxieties and preoccupations they described (Spearman’s rho r=-.30). Finally, as expected, satisfaction from GGRO was also related to less reported relationship anxieties and preoccupations (Spearman’s rho r=-.45).
Conclusions. Daily use of mobile technology aimed at challenging underlying relationship-related maladaptive beliefs may be associated with reduced relationship-related anxieties and preoccupations.
According to Associate Professor Guy Doron and his colleague Gur Ilany, the application developed (named ‘GG Relationship’) was especially designed for dealing with relationship doubts and fears. The application is based on the principles of Cognitive Behavioral Therapy (CBT) – one of the most research-supported psychological therapies.
According to CBT models, negative self-talk – individuals’ ongoing interpretations of the self, others and the world – maintain psychological difficulties such as obsessive preoccupation, low mood, and maladaptive behaviors. In ROCD, for instance, individuals negative self-talk often relates to fear of being in the wrong relationships or/and missing the ‘right’ relationship. Individuals with such fears will continuously say to themselves (in their heads) phrases such as ‘Maybe my partner is not the ONE’, ‘He is not smart enough for me’ or ‘I will regret my decision to stay/leave with my partner forever‘. Such negative self-talk, of course, ultimately increases relationship doubts/fears, intensifies negative mood and often provokes relationship conflict.
Associate Professor Guy Doron says ‘’GG Relationship’ was developed in order to provide an accessible CBT training platform that would allow individuals with relationship fears and doubts to better deal with negative self-talk’. According to Gur Ilany, the application is designed to ‘(1) increase individuals’ awareness of negative self-talk, (2) train individuals’ to better identify and challenge negative self-talk, (3) increase individuals’ access to neutral and positive self-talk, and (4) increase the automaticity of the above processes’. The core gameplay of the training is simple: individuals are presented with ‘blocks’ featuring self-talk statements such as “I am proactive”, “I am reliable” or “I am a loser”- and have to respond by pulling the supportive ‘blocks’ towards themselves (i.e., downwards) and throwing away from themselves the negative ‘blocks’ (i.e., rejecting them upwards).
A/Prof Doron says ‘to further strengthen learning of supportive self-talk, each level the player completes is followed by a small memory game in which one has to identify a supportive statements that appeared in the previous level’. As the game progresses, the individual passes through thematically relevant issues such as self-esteem, beliefs in change, dealing with relationship doubts, facing uncertainty, overcoming perfectionism, coping with embarrassment, commitment anxiety, etc.,. Training using this application, Gur says ‘will hopefully allow for gradual, steady learning of more positive self-talk thereby helping to break the vicious thought cycle maintaining relationship doubts and preoccupations’.