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Managing Family Accommodation in OCD: A Sibling-focused Case Study.

Archana Gupta1, Ajay Kumar1, Ts Jaisoorya2

  • 1Dept. of Clinical Psychology, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India.

Indian Journal of Psychological Medicine
|January 22, 2026
PubMed
Summary

Family accommodation (FA) in obsessive-compulsive disorder (OCD) significantly impacts caregivers. A caregiver-focused intervention reduced FA and distress when OCD patients refused treatment, highlighting the need for caregiver support.

Keywords:
Family accommodationcaregiver interventionclinical case studyobsessive-compulsive disordertreatment refusal

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Area of Science:

  • Psychiatry and Behavioral Sciences
  • Clinical Psychology

Background:

  • Family accommodation (FA) is common in obsessive-compulsive disorder (OCD), worsening outcomes and increasing caregiver burden, especially when patients decline treatment.
  • Structured, culturally sensitive interventions for FA and caregiver burden in adults with OCD, particularly when patients are non-adherent, are underdocumented.
  • Caregiver burnout is a significant issue when accommodating individuals with treatment-refusing OCD.

Purpose of the Study:

  • To describe a caregiver-focused intervention for managing family accommodation and caregiver burden in adult obsessive-compulsive disorder (OCD) when the patient refuses treatment.
  • To evaluate the feasibility and clinical utility of a caregiver-directed approach in a collectivist cultural context.
  • To assess the impact of the intervention on caregiver distress and family dynamics.

Main Methods:

  • A case study detailing an eight-session caregiver-focused intervention based on cognitive-behavioral principles.
  • Intervention targeted maladaptive caregiving patterns, boundary-setting, and caregiver behaviors.
  • Utilized post-intervention assessments and a one-month follow-up to measure outcomes.

Main Results:

  • The intervention led to significant reductions in family accommodation and emotional distress for the caregiver.
  • Caregiver gains were maintained at the one-month follow-up assessment.
  • The case demonstrates the effectiveness of caregiver-directed strategies in managing OCD-related family dynamics.

Conclusions:

  • Caregiver-focused interventions are feasible and clinically useful for adults with OCD, even when patients do not participate in treatment.
  • Structured support for caregivers is crucial, particularly in collectivist cultures.
  • Indirect interventions targeting caregivers can disrupt symptom-maintaining cycles and improve overall family well-being.