Treating OCD in Four Days

Gerd Kvale and Bjarne Hansen developed the Bergman protocol at Haukeland University Hospital in Bergen, Norway, 2011

Concentrated exposure therapy over four days can work

STUDY: Qutishat M et al, Acta Psychiatrica Scandinavica 2026

STUDY TYPE: Scoping review

FUNDING: Independent

Background

Cognitive behavioral therapy is the gold standard for OCD, but it a course of treatment takes several months. The Bergen 4-Day Treatment compresses that same exposure work, done in a small group with therapists, followed by a booster session at three months. The analysis brings together the research on it.

The Study

• 12 studies (3 randomized trials, the rest observational or pre-post), covering adults and adolescents with OCD in Norway, Iceland, the United States, and Germany.
• Compared the 4-day protocol against waitlist, self-help, or tracked patients before and after treatment.
• Follow-up ranged from 3 months to 4 years.

Response rates ran 83% to 95% across sites, with remission mostly landing between 68% and 80%. Against wait-list controls, effect sizes were large.

Gains held up well. One Norwegian cohort was still 69% recovered at four years, with only 18% relapsing.

Adolescents did about as well as adults, and family involvement reduced accommodating behaviors and OCD symptoms.

Adherence during treatment was a much stronger predictor of outcomes than motivation.

Limitations

Some trials used wait-list controls. Results weren’t uniform: A German trial found lower response (63%) and remission (47%) rates, below the 70-90% in the Norwegian sites where it was developed.

Practice Implications

1. If the Bergen protocol is a pragmatic match for your patient, consider it. Google the term to find a center near you.
2. Here’s a detailed summary of the treatment.

—Chris Aiken, MD
Director, Psych Partners
Editor in Chief, Carlat Psychiatry Report

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