Psychological therapies for OCD

The behvaioural explanation argues obesessions and complusions have been aquired through conditioning, so to recover the behaviour it must be unlearned. Obsessions are also maintained through avoidance     (negative reinforcement). Complusive rituals become associated with anxiety reduction and prevent relearning. 

Exposure and response prevention consists of two components; 

1. Exposure-    The patient is repeatedly prevented with the feared stimulus until anxiety subsides, this is called habituation.     Exposure may first be imagined and later experienced in VIVO.    Exposure may be moved gradually from least threatening, similar to desensitisation.   The underlying principle is that anxieties persist because of negative reinforcement-   avoidance of an anxiety provoking stimulus is reinforcing.  The cycle can be broken by the patient experiencing the stimulus and learning that it no longer produces anxiety. 

2. Response prevention-    At the same time as exposure takes place the patient is prohibited from engaging in the usual complusive response. The patients then learns that anxiety can be reduced without the compulsive ritual. If the patient manages to control the behaviour they, learn that obsessions that created anxiety no longer produce that response.  

ALBUCHER ET AL (98) report that  between 60 and 90 percent of adults with OCD have improved considerably using exposure and response prevention. 

FOA ET AL found found a combination of antidepressants and exposure response prevention was more effective than either alone. 

EDDY ET AL (04) compared it with cognitive therapy and cognitive behavioural therapy and found exposure response prevention was slightly more effective. 

However some findings show 25 to 30 percent of patients begin to drop out due to high anxiety levels. Also 20 percent dont benefit at all. 

ABRAMOWITZ identified three key factors in exposure response prevention not being totally successful; 

1. The therapist rathe than the patient contols the exposure situation. 

2. Response prevention is total rather than partial. 

3. It is more effective when emphasis is on the compulsion rather than the obsession.

The behvaioural explanation argues obesessions and complusions have been aquired through conditioning, so to recover the behaviour it must be unlearned. Obsessions are also maintained through avoidance     (negative reinforcement). Complusive rituals become associated with anxiety reduction and prevent relearning. 

Exposure and response prevention consists of two components; 

1. Exposure-    The patient is repeatedly prevented with the feared stimulus until anxiety subsides, this is called habituation.     Exposure may first be imagined and later experienced in VIVO.    Exposure may be moved gradually from least threatening, similar to desensitisation.   The underlying principle is that anxieties persist because of negative reinforcement-   avoidance of an anxiety provoking stimulus is reinforcing.  The cycle can be broken by the patient experiencing the stimulus and learning that it no longer produces anxiety. 

2. Response prevention-    At the same time as exposure takes place the patient is prohibited from engaging in the usual complusive response. The patients then learns that anxiety can be reduced without the compulsive ritual. If the patient manages to control the behaviour they, learn that obsessions that created anxiety no longer produce that response.  

ALBUCHER ET AL (98) report that  between 60 and 90 percent of adults with OCD have improved considerably using exposure and response prevention. 

FOA ET AL found found a combination of antidepressants and exposure response prevention was more effective than either alone. 

EDDY ET AL (04) compared it with cognitive therapy and cognitive behavioural therapy and found exposure response prevention was slightly more effective. 

However some findings show 25 to 30 percent of patients begin to drop out due to high anxiety levels. Also 20 percent dont benefit at all. 

ABRAMOWITZ identified three key factors in exposure response prevention not being totally successful; 

1. The therapist rathe than the patient contols the exposure situation. 

2. Response prevention is total rather than partial. 

3. It is more effective when emphasis is on the compulsion rather than the obsession.