Treatment of obsessive-compulsive disorder: Cognitive behavior therapy vs. exposure and response prevention. Behaviour Research and Therapy, 43, 1559-1576

Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada V6T 2B5.
Behaviour Research and Therapy (Impact Factor: 3.85). 01/2006; 43(12):1559-76. DOI: 10.1016/j.brat.2004.11.012
Source: PubMed


The efficacy of contemporary cognitive therapy for obsessive-compulsive disorder (OCD) has only recently been investigated. The current study compares exposure and response prevention (ERP) and cognitive behavior therapy (CBT) delivered in an individual format. Participants were randomly assigned to the 12 consecutive-week CBT or ERP treatment. Based on 59 treatment completers, there was no significant difference in YBOCS scores between CBT and ERP at post-treatment or at 3-month follow-up. A higher percentage of CBT participants obtained recovered status at post-treatment (67%) and at follow-up (76%), compared to ERP participants (59% and 58%, respectively), but the difference was not significant. Effect sizes (ESs) were used to compare the results of the current study with a previous study conducted at our center that utilized group CBT and ERP treatments, as well as other controlled trials that have compared CBT and ERP. The significance of these results is discussed and a comparison is made with the existing literature.

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    • "ı obsesyonlar ve kompülsiyonlar olmak üzere iki bileşenlidir. Bu iki bileşen kabaca ve yüzeysel olarak bilişsel ve davranışsal ögeler olarak değerlendirilebilir. Bu anlamda BDT'nin bu bileşenleri içererek etkili bir müdahale gerçekleştirmesi beklenir. Nitekim bunu kanıtlayan pek çok çalışma vardır (Fals-Stewart ve Lucente 1994, Braga ve ark. 2005, Whittal ve ark. 2005, Anderson ve Rees, 2007). OKB'nin tedavisinde BDT'nin etkili bir müdahale olduğu bilinmesine karşın uygulamalarda pratik problemlerle karşılaşılmaktadır. OKB toplumun %2.5'inde görülen yaygın bir bozukluktur (Karno ve ark. 1998) ve BDT ile tedavisi için bu formasyonla eğitilmiş terapist ve zaman problemi yaşanmaktadır. Bu nedenle, BDT'n"

    Preview · Article · Jan 2016
    • "Based on cognitive theories and previous research (Emmelkamp et al., 2002; Whittal et al., 2005), it was hypothesized that appraisals will change significantly following treatment and that this change would be significantly related to change in obsessive-compulsive symptoms. This study extends previous studies by using a larger OCD sample and by exploring possible differences in thought content in relation to appraisal and symptoms when delivering CBT for OCD. "
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    ABSTRACT: A premise for cognitive behavioral therapy (CBT) for obsessive-compulsive disorder (OCD) is that appraisal of obsessions maintains OCD symptoms whereas obsessive content is less important. The main aim of this study was therefore to explore this notion using the autogenous and reactive classification of obsessive content and by assessing changes in appraisals and symptoms following CBT for OCD. More specifically, the study investigates whether recovery from OCD is associated with changes in appraisal and explores how thought content relates to appraisal and symptoms both before and CBT. Data from 156 adults with OCD completing CBT for OCD were analyzed. Changes in appraisals were related to improvement in OCD symptoms. Slightly more participants reported reactive intrusions (47%) than autogenous (29%), but combinations of the two were common (24%). These classifications of thought content were not related to levels of appraisal or change in symptoms, with the exception of patients with autogenous thoughts who appraised their intrusions as more important than others. OCD is heterogeneous regarding thought content and strength of appraisals but can be quite homogeneous in terms of CBT treatment response. Also, and in line with cognitive theory, recovery from OCD is associated with changes in appraisals.
    No preview · Article · May 2015 · Journal of Cognitive Psychotherapy
    • "Multiple treatment trials have demonstrated the efficacy of CT as an intervention for OCD (e.g.,Emmelkamp & Beens, 1991;van Oppen et al., 1995;Wilhelm et al., 2005Wilhelm et al., , 2009). Most recently, results from an open trial (Wilhelm et al., 2005), waitlist controlled trial (Wilhem et al., 2009), and randomized-controlled trial (Whittal, Thordarson, & McLean, 2005), indicated that CT is associated with a significant reduction in patients' maladaptive obsessive beliefs, as well as OCD and depression symptom severity. Improvements have been shown to be maintained over time (i.e., up to a year). "
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    ABSTRACT: The current manuscript describes the rationale and pragmatics for conducting exposures (termed “behavioral experiments”) in Cognitive Therapy (CT) for OCD. Given that the cognitive model of OCD focuses upon the assumptions and belief systems (e.g., threat perception) that underlie the misinterpretation of unwanted intrusions, CT employs cognitive strategies, such as behavioral experiments, to modify maladaptive interpretations and produce symptom reduction. We outline how to prepare for behavioral experiments through psychoeducation and empirically supported assessment procedures. Next, we describe how to operationalize the behavioral experiment and propose patient and therapist-related behaviors that will facilitate (or interfere with) the experiment’s success. Lastly, we discuss how to process the findings of the behavioral experiment by integrating other CT strategies, such as calculation of harm and the downward arrow, to consolidate learning and ultimately strengthen and generalize skills use.
    No preview · Article · Jan 2015 · Journal of Obsessive-Compulsive and Related Disorders
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