What is the Bergen 4-Day Treatment?
What is the Bergen 4-Day Treatment?
The Bergen 4-Day Treatment (B4DT) is an intensive, exposure and response prevention (ERP) therapy with some unique characteristics and impressive outcomes at 3 months, 6 months, and at a long-term follow-up from 34-60 months (average 48 months) for the treatment of Obsessive-Compulsive Disorder (OCD). The treatment concentrates individual ERP sessions with a 1:1 therapist-patient ratio in a group format, and therapists may switch clients on subsequent days to allow more experienced therapists to work with patients with the smallest gains. The B4DT specifically emphasizes the LEan into The Anxiety (LET-technique), which encourages patients to expose themselves to as many anxiety provoking scenarios as they can during the intensive treatment. In order to enhance the treatment response, one of the inclusionary criteria is that patients lived within one hour, such that therapist assisted exposure could utilize highly relevant stimuli. It is also important to note in Hansen, Kvale, Hagen, Havnen, and Öst (2018), the therapists were very well trained in ERP and had extensive experience treating patients with OCD and that drop out rates were very low.
Day 1 focuses on psychoeducation preparing the patients for exposure and establishing the evidence and expectancies of treatment. Day 2 and Day 3, which can range from 8-10 hours per day utilize therapist assisted exposures utilizing the LET-technique in a variety of different settings. In between exposures, group meetings are held where patients share how the exposures are going using a scale of 1-6 (6 indicating fully “leaning” into the exposures). Loved ones are invited to attend a psychoeducational meeting on this day as well, to learn how they can be supportive. Day 4 focuses on how patients can continue independently to conduct their own exposures after treatment to maintain and/or improve, and to record how well they were doing these exposures for the next three weeks.
While more studies are welcome, incorporating the B4DT into your practice could offer clients a powerful tool to overcome their anxiety and improve their quality of life with a four-day treatment providing improvements then and training for clients to continue acting as their own therapist with the support of loved ones. The B4DT provides an excellent option for those seeking a concentrated and effective treatment modality with evidence that improvements can be maintained long-term.
Bergen Four-Day Treatment Study Outcome Highlights
Design: 77 OCD patients, YBOCS, follow ups 3, 6 months, 4 years
Results: Y-BOCS decreased from 25.9 at pre-treatment to 9.9 at long-term follow-up, 69% of the patients were classified as recovered at long-term follow-up.
Implications: The B4DT demonstrates long-term effectiveness in significantly reducing OCD symptoms with a 4-day treatment
References
Hansen, B., Kvale, G., Hagen, K., Havnen, A., & Öst, L. G. (2018). The Bergen 4-day treatment for OCD: Four years follow-up of concentrated ERP in a clinical mental health setting. Frontiers in Psychology, 9, 2111.
