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Psychotherapy and Your Obsessive-Compulsive Disorder

The psychotherapeutic treatment of choice is cognitive behavioral psychotherapy (CBT) for children, teens and adults with Obsessive-Compulsive Disorder (OCD).

CBT stands for: Cognitive Behavior Therapy. Behavior therapy helps individuals to learn ways to change what they are thinking and feeling by first changing their behavior. OCD behavior therapy involves something called, exposure and response prevention (E/RP).

The exposure part of (E/RP) stands for the fact that theory is the longer one is exposed to something that you fear the more the anxiety you experience is lessened.

The exposure needs to be combined with response or ritual prevention (RP) in order to be the most successful. When using (RP the individuals rituals or avoidance behaviors are blocked. An example would be someone who fears germs and usually washes hands repeatedly would do (RP) in a manner that they come into minimal contact with a object that perhaps touched another object that touched a contaminated item. There would not be allowed to be any washing of hands after touching this object that touched the germy item.

Cognitive Therapy or (CT) is often times added to E/RP to help reduce the occurrence of catastrophic thinking or the exaggerated sense of responsibility often experienced by those with OCD.

The usual pattern is to undergo several months of effective medication treatment first and then to pursue the following steps:

1. Give the patient an explanation of the rationale behind the therapy. The patient must be totally in agreement regarding the discomfort to be expected during the performance of the therapy. The usual time frame is that first the change in behavior is initiated, then after a week or more, anxiety decreases. After about a month, the associated obsessions decrease in both frequency and intensity.

2. Compare the relationship between the compulsion and the environmental events that take place (home, work) to other factors that either increase or decrease the compulsion.

3. Note what the patient avoids doing or exposing him/herself to so that the anxiety to that exposure can be avoided.

4. Analyze the thoughts, images or impulses that have the effect to increase anxiety or increase compulsion. Examine any occurrence of depression or actions from the family that may sustain the patients symptoms(cooperating with rituals or by creating stress).

5. Make note of the compulsions and avoidances from the least to the most anxiety producing.

6. Write down what exposure along with the response prevention will be worked on for two to three hours after exposure for either one or two compulsions per week. You start with the least anxiety-producing situations.

Therapy is more success when the therapist are respectful of the patient, are understanding of the process, are encouraging to the patient and the family members, challenge the patient to achieve a higher level and also keep informing the patient and family members on the progress being made.

Cognitive behavioral psychotherapy (CBT) works for children, teens and adults with Obsessive-Compulsive Disorder when combined with education, and an understanding therapist.