Combining Pharmacotherapy and Exposure Plus Ritual Prevention for Obsessive Compulsive Disorder: Research Findings and Clinical Applications

2005 ◽  
Vol 19 (4) ◽  
pp. 317-330 ◽  
Author(s):  
Martin E. Franklin ◽  
H. Blair Simpson
Keyword(s):  
Obsessive Compulsive Disorder ◽  
Behavioral Therapy ◽  
Combined Treatment ◽  
Comorbid Depression ◽  
Obsessive Compulsive ◽  
Case Examples ◽  
Compulsive Disorder ◽  
Negative Findings ◽  
Research Findings ◽  
Made In

The efficacy of cognitive-behavioral therapy (CBT) involving exposure and ritual prevention (EX/RP) for obsessive compulsive disorder (OCD) has been well documented, as has the efficacy of pharmacotherapy using serotonin reuptake inhibitors (SRIs). Response to these monotherapies is neither universal nor complete, however, and in the past 20 years significant progress has been made in examining the efficacy of combined EX/RP plus SRI treatment. Results of randomized controlled trials that have employed adequate methodology suggest that combined treatment may afford some advantages over the monotherapies, although the effect is generally not robust and there are some negative findings. Combined treatment may be especially useful in certain clinical circumstances, however, and case examples are provided describing the use of combined treatment for one patient who presented with comorbid depression and for another who refused EX/RP because he perceived it as too threatening.

Couple-Based Cognitive-Behavioral Therapy for Obsessive-Compulsive Disorder

2021 ◽  
pp. 370-383
Author(s):  
Jennifer L. Buchholz ◽  
Jonathan S. Abramowitz ◽  
Samantha N. Hellberg ◽  
Heidi J. Ojalehto
Keyword(s):  
Obsessive Compulsive Disorder ◽  
Symptom Severity ◽  
Behavioral Therapy ◽  
Response Prevention ◽  
Obsessive Compulsive ◽  
Global Functioning ◽  
Interpersonal Dynamics ◽  
Case Examples ◽  
Compulsive Disorder

For a number of reasons, it may be critical to involve a romantic partner or spouse in exposure and response prevention (ERP) for obsessive-compulsive disorder (OCD). Indeed, relationship stress focal to OCD is associated with greater symptom severity, a more severe course, and poor global functioning. Research also indicates that involving partners or spouses to serve as coaches for their OCD-affected partners during ERP improves the efficacy of this treatment. This chapter describes the nature and treatment of OCD, focusing on interpersonal dynamics, and outlines a couple-based ERP program for individuals with OCD who are in long-term relationships. Case examples are included to illustrate the techniques used in this program.

Cognitive Behavioral Treatment of Obsessive-Compulsive Disorder

2007 ◽  
pp. 431-446 ◽  
Author(s):  
Martin E. Franklin ◽  
Edna B. Foa
Keyword(s):  
Obsessive Compulsive Disorder ◽  
Behavioral Treatment ◽  
Behavioral Therapy ◽  
Combined Treatment ◽  
Empirical Support ◽  
Cognitive Behavioral ◽  
Cognitive Behavioral Treatment ◽  
Obsessive Compulsive ◽  
Compulsive Disorder

Cognitive behavioral therapy (CBT) involving exposure and ritual prevention (EX/RP) is a well-established treatment for obsessive-compulsive disorder (OCD) in adults. Support for its efficacy is derived from many Type 1 and Type 2 studies; more recently the literature on more cognitively based treatments for OCD has provided further empirical support for this approach as well. Combined treatment studies examining EX/RP plus serotonin reuptake inhibitors or clomipramine have provided some advantages for the combined regimen over the monotherapies, but equivocal findings have emerged as well. In recent years there has been increased attention paid to the treatment of pediatric OCD using CBT, and now there are several Type 1 studies documenting the efficacy of this approach for youth with OCD. Further research is needed to examine predictors of outcome and to examine the effectiveness of CBT for OCD in a variety of clinical settings.

Sexual Obsessions in Obsessive-Compulsive Disorder

2019 ◽  
Author(s):  
Monnica T. Williams ◽  
Chad T. Wetterneck
Keyword(s):  
Sexual Orientation ◽  
Cognitive Behavioral Therapy ◽  
Cognitive Therapy ◽  
Obsessive Compulsive Disorder ◽  
Behavioral Therapy ◽  
Intrusive Thoughts ◽  
Obsessive Compulsive ◽  
Case Examples ◽  
Compulsive Disorder

Although there have been several manuals written about how to treat obsessive-compulsive disorder (OCD) using cognitive-behavioral therapy (CBT), there has been little focus on application of CBT principles to those suffering from sexual obsessions. Treating sexual obsessions in OCD differs from the treatment of other forms of OCD due to heightened feelings of shame surrounding symptoms, widespread misdiagnosis from professionals, and the covert nature of ritualizing behaviors. This book provides clinicians with the tools needed to successfully help clients suffering from unwanted, intrusive thoughts of a sexual nature. It provides instructions on how to diagnose OCD in clients reporting sexual obsessions, guidance on measures to employ during assessment, and a discussion of differential diagnoses. It includes a step-by-step manual describing how to provide treatment, using a combination of exposure and ritual (response) prevention (Ex/RP), cognitive therapy, and newer CBT techniques. Also included are case examples of pedophile-themed OCD (sometimes called P-OCD) and sexual orientation worries in OCD (called SO-OCD or H-OCD) and their treatment approaches, along with a catalogue of specific ideas for in vivo exposures and detailed templates for imaginal exposures. Included are strategies therapists can use to tackle relationship issues that commonly emerge as a result of sexually themed OCD. Also included are appendices of handouts for clients and helpful measures for therapists to utilize with clients.

Using Cognitive-Behavioral Therapy to Treat Obsessive-Compulsive Disorder With Co-Occurring Depression

2019 ◽  
Vol 33 (3) ◽  
pp. 228-241 ◽  
Author(s):  
Michael G. Wheaton ◽  
Epifania Rita Gallina
Keyword(s):  
Cognitive Behavioral Therapy ◽  
Obsessive Compulsive Disorder ◽  
Behavioral Activation ◽  
Behavioral Therapy ◽  
Cognitive Behavioral ◽  
Future Research ◽  
Comorbid Depression ◽  
Obsessive Compulsive ◽  
Compulsive Disorder ◽  
The Impact

Many individuals with obsessive-compulsive disorder (OCD) also experience co-occurring depression, which may complicate OCD treatment. Some data suggest that OCD patients with comorbid depression experience less improvement with cognitive-behavioral therapy (CBT), the recommended psychotherapy for OCD. In particular, depression may interfere with an individual's adherence to the tasks of CBT, particularly exposure and response prevention (ERP). However, successful interventions exist for depression within CBT, including both cognitive therapy and behavioral activation, which can be added in treating OCD patients with depression. This article reviews the literature on the impact of comorbid depression on OCD treatment and then describes the treatment of an adult with both conditions. This case history demonstrates how depression-specific interventions can be incorporated into standard ERP to maximize OCD treatment gains. We also review important practice points for treating clinicians and areas for future research.

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