ROANOKE TIMES
Copyright (c) 1996, Roanoke Times
DATE: Thursday, May 9, 1996 TAG: 9605090074
SECTION: NATIONAL/INTERNATIONAL PAGE: A-1 EDITION: METRO
DATELINE: NEW YORK
SOURCE: Associated Press NOTE: Below
People driven by obsessions and compulsions such as excessive handwashing got significant relief when treated over the phone by a computer that said such things as, ``Is cleaning or washing a major problem for you? If yes, press 1. If no, press 2.''
The computer, along with a written manual, helped the patients plan exercises that taught them to control their urges, said researcher Dr. John Greist.
This behavior-modifying strategy has been shown to be effective, but it's not widely offered by human therapists, Greist said. The high-tech approach, in contrast, can be available anywhere there is a push-button phone.
Greist, a psychiatrist at the Dean Foundation in Madison, Wis., spoke in an interview before he was to present the results of his technique Wednesday at the annual meeting of the American Psychiatric Association.
An estimated 5 million Americans have obsessive-compulsive disorder, which is marked by unwanted, anxiety-provoking thoughts, usually with ritual behavior to relieve the anxiety. The rituals can occupy several hours a day, interfering with normal life.
Common obsessions include fears of being contaminated, harming another person or making a mistake. Common rituals include handwashing, checking locks and arranging objects in a precise order. People with the disorder understand the rituals are foolish but can't avoid them.
The idea behind the behavior-modifying strategy is for patients to learn that if they delay the anxiety-relieving ritual long enough, the anxiety will go away. Eventually, they learn to control the anxiety without the ritual behavior, Greist said.
For the study, researchers programmed a computer to react to information patients entered with a push-button phone, and to talk back with more than 700 taped messages. Patients, who were diagnosed and referred to the program by a mental health professional, also used a printed workbook.
Patients entered such information as how many hours a day they spent on their rituals, how much money they spent on expenses such as extra soap for excessive handwashing and which of more than 170 situations or objects triggered their obsessions.
They learned to identify precisely what set off their obsessions, perhaps a particular doorknob they thought gave them germs. And they set specific goals like touching that doorknob, and then touching their countertops and bed linen at home without washing for three hours thereafter. Patients tape-recorded this goal over the phone, and it was replayed for them later, when they were ready to go out and try it.
Later, they would call back and tell the computer how their attempt went, with information regarding how much anxiety they felt.
They were instructed to try to meet the goal each day, and they repeatedly made their goals more precise, combined multiple goals and put off their rituals longer and longer.
Patients received weekly computer-generated reports on their progress.
Patients could set their own pace through the program, calling as often as they wished. The service was available around the clock.
LENGTH: Medium: 62 linesby CNB