An Apology And Update On Our Resource Development Process

We recently released a resource titled Exposures For Fears Related To Religion, which was developed for clinicians working with individuals who struggle with scrupulosity in the context of OCD. It was part of a larger Exposures For… series, which aims to help clinicians explore potential exposure exercises with their clients.

Some of our members raised concerns about this resource soon after it was published, and it was immediately removed from our library. We take any concerns about our materials extremely seriously and recognize that this resource has caused offence and distress. We want to offer a sincere apology and explain how we got this wrong, what we’ve learned, and what we’ve changed as a result.

We didn’t get it right

Our intention with this series was to help clinicians generate ideas for exposure exercises and inform their discussions with clients. While some exposure tasks for OCD can seem extreme when taken out of context, we recognize that the tasks described in this resource could violate religious laws and sensibilities, rather than helping clients face their doubts and uncertainties in a way that is formulation-driven while also respecting and upholding their religious beliefs and practices (e.g., [1]).

The development process for this resource was inadequate. When we created it, we consulted internally with our team of clinicians. This included a review by a clinical psychologist from a faith background, who has experience treating religious concerns in OCD. Failing to involve the broader faith community – including faith leaders and people with lived experience – was a serious oversight; we should have consulted much more widely. Though we drew upon a variety of literature to develop this series, it should have included more published case material relating to the use of ERP in treatments for scrupulosity as well as more detailed clinical guidance.

We understand that these were significant omissions, and that the exposure tasks suggested in the resource were insensitive and potentially counter-therapeutic. We deeply regret this and are very sorry for the offense this has caused.

What have we done, and what will we do in future?

Since the initial concern about this resource was raised in September, we have implemented several important changes:

• The Exposures For Fears Related To Religion resource has been removed from our library.
• We’ve written to each user who downloaded this resource to apologize for any offence caused, explore their experience of it, and ask for feedback on how to improve. Our sincere thanks to everyone who engaged with us.
• We’re expanding our review panel to help us to ensure that our resources are inclusive and fulfil their therapeutic intention. We have recruited a large new group of experienced clinicians from different faiths and backgrounds, including many who have lived experience with mental health difficulties, and are beginning a systematic review of new and existing resources. We’ll also accelerate our plans to roll out a system for collecting client and therapist feedback on our resources.
• We appreciate that some therapy resources should only be used with close professional guidance. These resources are no longer available on our website as ‘Client version’ downloads, as the ‘Professional versions’ can offer more detailed therapist guidance. We’ve applied this change to the entire Exposures For… series.
• We’ll continue to review our existing resources for their inclusivity and clinical utility.

We’re very grateful to members who voiced their concerns, and to those who have engaged in dialogue with us since then. We welcome any feedback on how we can improve. If you have any suggestions, please contact us at [email protected].

References

[1] Abramowitz, J. S., & Jacoby, R. J. (2014). Scrupulosity: A cognitive–behavioral analysis and implications for treatment. Journal of Obsessive-Compulsive and Related Disorders, 3 (2), 140-149. DOI: 10.1016/j.jocrd.2013.12.007.