Psychological Therapies for OCD

Summary of psychological therapies for OCD, including behavioural and cognitive therapies.

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Psychological Therapies for OCD
Behavioural therapy Exposure Response Prevention (ERP) therapy
F o cus on
cha ngi
ng
b eh aviour
1. Exposure
A n xi
eties e xi
std
u e to n eg ati
ve r ei
nforceme nt(
a v oi
da nce)
.C
y cl
ei sb
r oke nb
y
ex per
ienc ew
i t
hs
t i
mu l
usa n dt
heyl
e ar
n
througha
s s oci
ati
ona
n dr
elaxati
o n
t hat
i
t
no
longer produces anxiet
y.
P a t
ienti
s repeatedly exposed t
ot
h ef e ar eds
timulu su
n ti
l
thea n xi
e t
y
su bsi
de s
(habit
uati
on
)
Ma y imagine fi
rst
a nd
later
e xper
ience in
vivo (e.g.
t
ouch ing
d i
rt
y i
tem)
E xpo sur
esma
ymo v ef rom least to most threatening (
s i
milar
toS
D ),
b ut
i
f
pa ce
is t
oo sl
ow ,
patien t
ma y
l ose
mo t
ivati
on
2. Response prevention
At t
h es
a met ime, p at
ient
i s prohibited fr om doi
ngu
s ual
compulsive
response,
a ndt
h eyr
eco gn i
s ea
n xi
e tyc
a nb
er ed uc edw
i t
hout
comp ulsi
o na
n d
learn
the a nxi
ety
w i
ll
no l
ong er
produc e t
he comp ulsive
response
P a ti
ents enco ur
a ged t
o con t
inue u si
n g E R P techni
qu es outside of
sessions,
app l
ying
to new
sit
u ati
ons t
ha t
ari
s e
Effective
6090% pat
ient
s sh ow s i
gnif
icanti
mp rovementa
c cor
ding t
o
di
fferen t
st
udies
E ff
e ct
ivene ss
depends on effort
put
inb
yp ati
ent
(ar
et
hey pr
eparedt
o
do t
heir
" homework"
an d
p ut
me thods
int
o act
ion
out
side
of
sessi
ons?)
May not be appropriate for all:
time consuming
Typicall
y 1320
w e ekly
s e ssion s
Mo nthl
y booster
ca n be ad de d f
o r
up
to
6 m aft
er pr
event rel
apse
Doe sn'
t work
for
thos e also very depressed
Do esn't
w orkf
or thosew i t h certain types o f
OC D behav i
our,
sucha
s
hoarding, per
ha psa
si t mi ght be evolutionary? propose st
hew
a nt
t
o
hoa rd
thi
n gs
is
a cha racter i
s ti
c
tha t
has evolved
for
sur
viva
l
Mor
e ef
fect
ive
w hen
combi
ned
w i
thcognitive techniques
Cognitive therapy (CT)
I de nti
fi
es ,
chall
enges and mo dif
ies dysf
u ncti
o nal
b el
ief
s
Obsessions
Ther
a pist
q uestions
h ow pat
ient
interprets t
heir
b eli
ef s,
i
ncludi
n g
w hy
they
thi
nk
the
obsession deve l
oped and why t
he y
think i
t'
s t
rue
The
be li
e f
s
are challenged and reinterpreted.
Compulsions
Ther
a pist
q uestions
value of
comp u l
sive behav io ur
d oes i
t
eve n
hel
p?
Bel
ief
i
s challenged and conf
ron t
ed
a s
false,
so hel
ps cont
rol
behaviou
r
Thought records
Pa t
ients
k eep dai
ly
record of
intr
us i
ve t
ho ug ht
s

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How
they fel
t
Wh at
t
h eir
r
e s ponse
w as
How
they cha ll
enged the thoughts
and r
esponses
Ther
apist
discusses t
hough t
rec or
d wit
h pat
ient
and
challenges unr eal
ist
ic
bel
ief
s
so
pati
ent
w i
ll
recognise irrational nature
of
beli
efs
and responses
Des pite
evi
dence
that
CT al
one
can improve symptoms
by 20%,
it
i
s rarely used
on its own
(combined
w i…read more

Comments

MrsMacLean

Really useful information on Psychological therapies for OCD :-)

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