Current Issues in Behavior and Cognitive Therapy for Obsessive-Compulsive Disorder

CNS Spectrums ◽  
1996 ◽  
Vol 1 (1) ◽  
pp. 47-54 ◽  
Author(s):  
Fugen Neziroglu ◽  
Jonathan Hoffman ◽  
Jose A. Yaryura-Tobias ◽  
David Veale ◽  
Jean Cottraux
Keyword(s):  
Cognitive Therapy ◽  
Obsessive Compulsive Disorder ◽  
Behavior Therapy ◽  
Primary Care Physicians ◽  
Psychological Treatment ◽  
Medication Compliance ◽  
Rational Emotive Behavior Therapy ◽  
Obsessive Compulsive ◽  
Compulsive Disorder ◽  
Complex Forms

AbstractExposure and response prevention (ERP), a form of behavior therapy, is widely recognized as the most effective psychological treatment for obsessive-compulsive disorder (OCD). Cognitive therapy (meaning rational emotive behavior therapy [REBT], or the Salkovskis model for this article) has received increased attention as an effective method for OCD treatment. These methods have renewed hope for patients suffering with what had long been thought to be a treatment refractory condition. Yet many important issues require further discussion and investigation. At the Second International Conference on OCD, which was held in Guadeloupe, February 14–16, 1996, the following issues were highlighted:1. Which psychotherapies are effective in the treatment of OCD?2. What psychological strategies may be used to increase patient motivation during treatment?3. Are relapse prevention strategies necessary after improvement?4. How do economic factors affect the use of behavior therapy? How is OCD treatment uniform or varying from specialty providers to mental health generalists to primary care physicians? How do self-administered and therapist-administered ERP compare?5. How does the efficacy of ERP or cognitive therapy and pharmacotherapy (either alone or in combination) compare?6. Is ERP effective for complex forms of OCD?7. In OCD treatment, is medication compliance improved if ERP or cognitive therapy is also used, and vice versa? How does this affect relapse rates? In addition, can doses of medications be lowered with the addition of ERP or cognitive therapy?8. What is known about the brain function and biological changes associated with ERP and cognitive therapy?

scholarly journals Cognitive Therapy versus Fluvoxamine as a Second-Step Treatment in Obsessive-Compulsive Disorder Nonresponsive to First-Step Behavior Therapy

2012 ◽  
Vol 81 (6) ◽  
pp. 366-374 ◽  
Author(s):  
Anton J.L.M. van Balkom ◽  
Paul M.G. Emmelkamp ◽  
Merijn Eikelenboom ◽  
Adriaan W. Hoogendoorn ◽  
Johannes H. Smit ◽  
...  
Keyword(s):  
Cognitive Therapy ◽  
Obsessive Compulsive Disorder ◽  
Behavior Therapy ◽  
Second Step ◽  
Obsessive Compulsive ◽  
Compulsive Disorder

Cognitive Therapy for Obsessive Compulsive Disorder

2000 ◽  
Vol 14 (3) ◽  
pp. 245-259 ◽  
Author(s):  
Sabine Wilhelm
Keyword(s):  
Cognitive Therapy ◽  
Obsessive Compulsive Disorder ◽  
Psychological Treatment ◽  
Response Prevention ◽  
Exposure And Response Prevention ◽  
Obsessive Compulsive ◽  
Compulsive Disorder ◽  
Treatment Techniques ◽  
Current Psychological ◽  
Therapy Studies

Cognitive therapy for Obsessive-Compulsive Disorder (OCD) may be at least as effective and less stressful as the current psychological treatment of choice, exposure and response prevention (ERP). Cognitive therapy studies will be reviewed and a case example used to illustrate specific cognitive treatment techniques.

Behaviour Therapy for Obsessive—Compulsive Disorder: A Decade of Progress

1997 ◽  
Vol 42 (10) ◽  
pp. 1021-1027 ◽  
Author(s):  
Isaac Marks
Keyword(s):  
Cognitive Therapy ◽  
Obsessive Compulsive Disorder ◽  
Social Adjustment ◽  
Psychological Treatment ◽  
Antidepressant Medication ◽  
Behaviour Therapy ◽  
Obsessive Compulsive ◽  
Pilot Studies ◽  
Compulsive Disorder

Objective: To review the last decade of behaviour therapy research in obsessive–compulsive disorder (OCD). Method: The most salient research was analyzed. Results: Many studies confirmed that exposure and ritual prevention (ERP) effectively reduced compulsive rituals and obsessive thoughts in most patients in all age groups, although a minority of the patients did not complete treatment. Gains persisted to follow-up 2 to 6 years later in several countries. Improvement after ERP generalized to obsessive–compulsive beliefs, mood, work, and social adjustment, and was accompanied by reduction in cerebral blood flow in the right caudate nucleus. Teaching patients how to prevent relapse seems to reduce the risk of recurrence. ERP yields slightly more improvement than does appropriate antidepressant medication and is followed by far less relapse after treatment has stopped, so ERP may be more cost-effective in the long term. Antidepressant medication is a useful adjunct to ERP when OCD is accompanied by comorbid depression. The therapist now tends to teach patients how to carry out self-exposure and self-imposed ritual prevention, rather than to impose ERP on them. Self-help manuals help patients to do this, and computer aids to allow patients to learn how to do ERP at home have been valuable in pilot studies. Cognitive therapy without ERP was as useful as ERP. Conclusion: ERP is of lasting value for OCD. Long-term cost-effectiveness comparisons are needed of self-administered ERP versus cognitive therapy and versus medication. Studies are also needed of brief psychological treatment for depression comorbid with OCD.

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