(PS7-D78) Clinician Perceptions and Practice of Using Exposure-based Therapy to Treat OCD in Pregnancy

Perinatal OCD affects up to 8% of pregnant people and up to 16% of people in the postpartum period and when left untreated can have negative impacts on both the parent and infant. Exposure and Response Prevention (ExRP) is one of the most well-studied and efficacious psychotherapies for OCD. It is also considered to be safe and tolerable and has been recommended for treatment in perinatal populations although little efficacy data is available. Nonetheless, clinicians are often hesitant to implement ExRP and have raised concerns about the safety and tolerability of using exposure-based therapies generally. We examine whether this reluctance is magnified when clinicians decide whether to implement exposure-based therapies for vulnerable populations such as pregnant people. Thus, we administered a cross-sectional online survey to a sample of clinicians that assess or treat OCD, and examine clinical experiences treating OCD in pregnancy. We assess perceptions of tolerability and safety and reservations about recommending and utilizing exposure-based therapies in pregnancy. In particular, we ask questions about the type of treatment used for OCD in pregnancy, clinician reservations about ExRP, clinician experiences and patient outcomes when using ExRP in pregnancy, and other types of treatment used to treat OCD in pregnancy. The survey also includes a validated measure of beliefs about exposure therapy (TBES). In addition to reporting topline results, we also compare perceptions and beliefs between clinicians who differ in their level of training and their experience in treating perinatal OCD.  This research identifies potential obstacles to disseminating and implementing evidence-based practice with perinatal populations. It also suggests opportunities and challenges for future research, training opportunities, and outreach to perinatal clinicians.