Résumés
Résumé
En termes de prévalence, le trouble obsessionnel-compulsif (TOC) se classe au quatrième rang des troubles de santé mentale. Les traitements actuellement dispensés sont issus de la première et de la deuxième vague des thérapies comportementales et cognitives et utilisent l’exposition et la restructuration cognitive. Cependant, les thérapies de la troisième vague, soit la thérapie par la pleine conscience et la thérapie d’acceptation et d’engagement (ACT), sont de plus en plus reconnues comme traitements de choix. Le présent article décrit les bases théoriques de l’ACT, incluant la théorie des cadres relationnels et ses cibles cliniques : l’évitement expérientiel, ses principaux processus et un outil utilisé lors du traitement, la matrice. Plutôt que de restructurer les pensées problématiques et de l’exposer à son anxiété, l’ACT vise à entraîner la flexibilité psychologique, c’est-à-dire la capacité à se distancer de ses pensées problématiques et à accepter les ressentis inconfortables afin de pouvoir poser des actions en lien avec ses valeurs personnelles. Ceci peut permettre au comportement du client qui était largement sous le contrôle aversif de ses obsessions et de son anxiété de passer graduellement sous le contrôle appétitif de ses valeurs personnelles. L’application de l’ACT au TOC est illustrée par une étude de cas.
Mots-clés :
- trouble obsessionnel,
- acceptation et engagement,
- cadre relationnel,
- modèle de la matrice,
- étude de cas
Abstract
In terms of prevalence, Obsessive compulsive disorder is the 4th ranked psychiatric disorder. Current treatments include 1st and 2nd wave cognitive behavioural therapies involving exposure and cognitive restructuring. However, 3rd wave therapies such as mindfulness and acceptance and commitment therapy (ACT) are also increasingly recognized as treatments of choice. The current article describes the underlying theory of ACT including relational frame theory, its clinical target: experiential avoidance, its main processes and a tool for the delivery of ACT to patients, the matrix. Rather than aiming to restructure problematic thoughts and evaluations, ACT seeks to train psychological flexibility, the ability to distance from problematic thoughts and accept uncomfortable emotion in the service of engaging personally valued actions. This can help move patient behaviour away from the aversive control of anxiety and obsessions and toward the appetitive control of personal values. The application of ACT to OCD is illustrated by a successful case study.
Keywords:
- obsessive-compulsive disorder,
- acceptance and commitment,
- relational frames,
- Matrix Model,
- case study
Parties annexes
Bibliographie
- Aardema, F., Emmelkamp, P. M. G. et O’Connor, K. P. (2005). Inferential confusion, cognitive change and treatment outcome in obsessive-compulsive disorder. Clin Psychol Psychother, 12(5), 338-345.
- Abramowitz, J. S. (2006). The psychological treatment of obsessive-compulsive disorder. Can J Psychiatry, 51(7), 407-416.
- Abramowitz, J. S., Lackey, G. R. et Wheaton, M. G. (2009). Obsessive-compulsive symptoms : the contribution of obsessional beliefs and experiential avoidance. J Anxiety Disord, 23(2), 160-166.
- Adam, Y., Meinlschmidt, G., Gloster, A. T. et Lieb, R. (2011). Obsessive-compulsive disorder in the community : 12-month prevalence, comorbidity and impairment. Soc Psychiatry Psychiatr Epidemiol. doi : 10.1007/s00127-010-0337-5
- Armstrong, A. B. (2012). Acceptance and commitment therapy for adolescent obsessive-compulsive disorder. (Ph.D. 3489428), Utah State University, United States – Utah. Retrieved from http://ezproxy.qa.proquest.com/docview/915562954?accountid=14771 ProQuest Dissertations & Theses (PQDT) database.
- Beck, A. T. (1976). Cognitive therapy and the emotional disorders. International Universities Press.
- Beck, A. T., Epstein, N., Brown, G. et Steer, R. A. (1988). An inventory for measuring clinical anxiety : psychometric properties. J Consult Clin Psychol, 56(6), 893-897.
- Beck, A. T., Steer, R. A. et Carbin, M. G. (1988). Psychometric properties of the Beck Depression Inventory : Twenty-five years of evaluation. Clin Psychol Rev, 8(1), 77-10.
- Bobes, J., González, M. P., Bascarán, M. T., Arango, C., Sáiz, P. A. et Bousoño, M. (2001). Quality of life and disability in patients with obsessive-compulsive disorder. European Psychiatry, 16(4), 239-245.
- Bond, F. W., Hayes, S. C., Baer, R. A., Carpenter, K. M., Guenole, N., Orcutt, H. K., … et Zettle, R. D. (2011). Preliminary Psychometric Properties of the Acceptance and Action Questionnaire–II : A Revised Measure of Psychological Inflexibility and Experiential Avoidance. Behav Ther, 42(4), 676-688.
- Boulanger, J. L., Hayes, S. C. et Pistorello, J. (2010). Experiential Avoidance as a functional contextual concept. Dans A. Kring et D. Sloan (dir.), Emotion Regulation and Psychopathology (p. 125-162). New York : Guilford Press.
- Bourque, P. et Beaudette, D. (1982). Étude psychométrique du questionnaire de dépression de Beck auprès d’un échantillon d’étudiants universitaires francophones. Canadian Journal of Behavioural Science/Revue canadienne des sciences du comportement, 14(3), 211-218.
- Briggs, E. S. et Price, I. R. (2009). The relationship between adverse childhood experience and obsessive-compulsive symptoms and beliefs : The role of anxiety, depression, and experiential avoidance. J Anxiety Disord, 23(8), 1037-1046.
- Brown, K. W. et Ryan, R. M. (2003). The benefits of being present : mindfulness and its role in psychological well-being. J Pers Soc Psychol, 84(4), 822-848.
- Cottraux, J., Bouvard, M. A. et Milliery, M. (2005). Combining Pharmacotherapy with cognitive-behavioral interventions for obsessive-compulsive disorder. [Review]. Cogn Behav Ther, 34(3), 185-192.
- Ciarrochi, J., Bilich, L. et Godsel, C. (2010). Psychological flexibility as a mechanism of change in Acceptance and Commitment Therapy. Dans Ruth Baer’s (dir.), Assessing Mindfulness and Acceptance : Illuminating the Processes of Change (p. 51-76). Oakland, CA : New Harbinger Publications, Inc.
- Dymond, S., May, R. J., Munnelly, A. et Hoon, A. E. (2010). Evaluating the evidence base for relational frame theory : a citation analysis. Behav Anal, 33(1), 97-117.
- Eisen, J. L., Mancebo, M. A., Pinto, A., Coles, M. E., Pagano, M. E., Stout, R. et Rasmussen, S. A. (2006). Impact of obsessive-compulsive disorder on quality of life. Compr Psychiatry, 47(4), 270-275.
- First, M. B., Williams, J. B. W., Spitzer, R. L. et Gibbon, M. (2007). Structured Clinical Interview for DSM-IV-TR Axis I Disorders, Clinical Trials Version (SCID-CT). New York : Biometrics Research, New York State Psychiatric Institute.
- Foa, E. B., Franklin, M. E. et Moser, J. (2002). Context in the clinic : how well do cognitive-behavioral therapies and medications work in combination ? Biol Psychiatry, 52(10), 987-997.
- Freeston, M. H., Ladouceur, R., Thibodeau, N., Gagnon, F. et Rhéaume, J. (1994). [The Beck Anxiety Inventory. Psychometric properties of a French translation.] Encephale, 20(1), 47-55.
- Gillanders, D. T., Bolderston, H., Bond, F. W., Dempster, M., Flaxman, P. E., Campbell, L., Kerr, S., Tansey, L., Noel, P., Ferenbach, C., Masley, S., Roach, L., Lloyd, J., May, L., Clarke, S. et Remington, R. (sous presse) The development and initial validation of The Cognitive Fusion Questionnaire. Behavior Therapy.
- Goodman, W. K., Price, L. H., Rasmussen, S. A., Mazure, C., Delgado, P., Heninger, G. R. et Charney, D. S. (1989). The Yale-Brown Obsessive Compulsive Scale. II. Validity. Arch Gen Psychiatry, 46(11), 1012-1016.
- Goodman, W. K., Price, L. H., Rasmussen, S. A., Mazure, C., Fleischmann, R. L., Hill, C. L., … et Charney, D. S. (1989). The Yale-Brown Obsessive Compulsive Scale. I. Development, use, and reliability. Arch Gen Psychiatry, 46(11), 1006-1011.
- Hanstede, M., Gidron, Y. et Nyklicek, I. (2008). The effects of a mindfulness intervention on obsessive-compulsive symptoms in a non-clinical student population. J Nerv Ment Dis, 196(10), 776-779.
- Hayes, S. C. (2004). Acceptance and commitment therapy, relational frame theory, and the third wave of behavioral and cognitive therapies. Behavior Therapy, 35(4), 639-665.
- Hayes, S. C., Barnes-Holmes, D. et Roche, B. (dir.) (2001). Relational Frame Theory : A Post-Skinnerian account of human language and cognition. New York : Plenum Press.
- Hayes, S. C., Luoma, J. B., Bond, F. W., Masuda, A. et Lillis, J. (2006). Acceptance and commitment therapy : model, processes and outcomes. Behav Res Ther, 44(1), 1-25.
- Hayes, S. C., Strosahl, K. et Wilson, K. G. (1999). Acceptance and Commitment Therapy : An experiential approach to behavior change. New York : Guildford.
- Hayes, S. C., Strosahl, K. et Wilson, K. G. (2011). Acceptance and commitment therapy : The process and practice of mindful change (2e édition). New York : Guildford.
- Hayes, S. C., Strosahl, K. D., Bunting, K., Twohig, M. P. et Wilson, K. G. (2004). What is acceptance and commitment therapy ? Dans S. C. Hayes et K. D. Strosahl (dir.), A practical guide to Acceptance and Commitment Therapy. New York : Springer Verlag.
- Hayes, S. C., Wilson, K. W., Gifford, E. V., Follette, V. M. et Strosahl, K. (1996). Experiential avoidance and behavioral disorders : A functional dimensional approach to diagnosis and treatment. Journal of Consulting and Clinical Psychology, 64(6), 1152-1168.
- Horwath, E. et Weissman, M. M. (2000). The epidemiology and cross-national presentation of obsessive-compulsive disorder. Psychiatr Clin North Am, 23(3), 493-507.
- Kabat-Zinn, J. (2009) Au coeur de la tourmente, la pleine conscience : MBSR, la réduction du stress basée sur la mindfulness. Bruxelles : De Boeck.
- Khoury, B., Lecomte, T., Fortin, G., Masse, M., Therien, P., Bouchard, V.,… et Hofmann, S. G. (2013). Mindfulness-based therapy : a comprehensive meta-analysis. Clin Psychol Rev, 33(6), 763-771.
- Mollard, E., Cottraux, J. et Bouvard, M. (1989). [French version of the Yale-Brown Obsessive Compulsive Scale.] Encephale, 15(3), 335-341.
- O’Connor, K. et Aardema, F. (2011). Clinician’s Handbook for Obsessive Compulsive Disorder : Inference-Based Therapy. London : Wiley-Blackwell.
- Öst, L. G. (2008). Efficacy of the third wave of behavioral therapies : a systematic review and meta-analysis. Behav Res Ther, 46(3), 296-321.
- Polk, K. et Schoendorff, B. (dir.) (2014). The ACT Matrix. Oakland : New Harbinger.
- Powers, M. B., Zum Vorde Sive Vording, M. B. et Emmelkamp, P. M. (2009). Acceptance and commitment therapy : a meta-analytic review. Psychother Psychosom, 78(2), 73-78.
- Pull, C. B. (2009). Current empirical status of acceptance and commitment therapy. Curr Opin Psychiatry, 22(1), 55-56.
- Raes, F., Pommier, E., Neff, K. D. et Van Gutch, D. (2011). Construction and Factorial Validation of a Short Form of the Self-Compassion Scale. Clinical Psychology & Psychotherapy, 18, 250-255.
- Rasmussen, S. A. et Eisen, J. L. (2002). The course and clinical features of obsessive-compulsive disorder. Dans K. L. Davis, Charney, D., Coyle, J. T. et Nemeroff, C. (dir.), Neuropsychopharmacology : The Fifth Generation of Progress (p. 1593-1608). Philadelphia : Lippincott Williams & Wilkins.
- Ruscio, A. M., Stein, D. J., Chiu, W. T. et Kessler, R. C. (2010). The epidemiology of obsessive-compulsive disorder in the National Comorbidity Survey Replication. Mol Psychiatry, 15(1), 53-63.
- Schoendorff, B., Putois, B., Mollard, E. et Barnel, C. (2009, décembre). Étude pilote de prise en charge en groupe par l’ACT de patients TOC rechutés et/ou résistants et souffrant de comorbidité et suivi à 1 an. Communication présentée aux 37es journées scientifiques de l’Association Française de Thérapie Comportementale et Cognitive, Paris.
- Schoendorff, B., Grand, J. et Bolduc, M.-F. (2011). La thérapie d’acceptation et d’engagement, Guide clinique. Bruxelles : De Boeck.
- Segal, Z., Williams, J. M. et Teasdale, J. D. (2002). Mindfulness-Based Cognitive Therapy for Depression. New York : The Guildford Press. Traduction française : La thérapie cognitive basée sur la pleine conscience. Bruxelles, De Boeck, 2006.
- Shafran, R. et Rachman, S. (2004). Thought-action fusion : a review. J Behav Ther Exp Psychiatry, 35(2), 87-107.
- Skinner, B. F. (1957). Verbal Behavior, New Ork, Prentice Hall.
- Skoog, G. et Skoog, I. (1999). A 40-year follow-up of patients with obsessive-compulsive disorder. Arch Gen Psychiatry, 56(2), 121-127.
- Smout, M. et Davies, M. (2011). The Valuing Questionnaire. Paper presented at the Fifth World conference of the Association for a Contextual Behavioral Science, Parma.
- Twohig, M. P., Hayes, S. C. et Masuda, A. (2006). Increasing willingness to experience obsessions : acceptance and commitment therapy as a treatment for obsessive-compulsive disorder. Behav Ther, 37(1), 3-13.
- Twohig, M. P., Hayes, S. C., Plumb, J. C., Pruitt, L. D., Collins, A. B., Hazlett-Stevens, H. et Woidneck, M. R. (2010). A randomized clinical trial of acceptance and commitment therapy versus progressive relaxation training for obsessive-compulsive disorder. J Consult Clin Psychol, 78(5), 705-716.
- Twohig, M. P., Moran, D. J. et Hayes, S. C. (2007). A functional contextual account of Obsessive Compulsive Disorder. Dans D. X. Woods et Kanter, J. (dir.), Understanding Behavior Disorders. Reno, NV : Context Press.
- Webster, M. (2014). Rolling out the matrix, rolling back addiction. Dans K. Polk et B. Schoendorff (dir.), The ACT Matrix, Oakland : New Harbinger, 81-96.
- Wenzlaff, R. M. et Wegner, D. M. (2000). Thought suppression. Annu Rev Psychol, 51, 59-91.
- Wilkinson-Tough, M., Bocci, L., Thorne, K. et Herlihy, J. (2010). Is mindfulness-based therapy an effective intervention for obsessive-intrusive thoughts : a case series. Clin Psychol Psychother, 17(3), 250-268.