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Re:Cognitive interventions for OCD?
Jim Pretzer · 01/24/01 at 9:10 PM ET
The current "state-of-the-art" Cognitive Therapy approach to OCD emphasizes Exposure and Response-Prevention (E&RP) as central to treating OCD effectively. The behavioral interventions are essential for treating OCD effectively. Using standard cognitive techniques to challenge automatic thoughts and dysfulctional beliefs can be quite useful with OCD but this must be combined with E&RP. Having said that, I'd argue that cognitive interventions are very useful. They can greatly facilitate getting clients to follow through on E&RP, especially when you are doing outpatient therapy and the client is doing much of the E&RP on their own. They can be useful in addressing non-compliance, in interrupting the chain of thoughts and feelings that lead to compulsive rituals, etc. My recollection is that several studies have found that cognitive interventions alone are as effective as behavioral interventions alone in treating OCD (but no more effective). However, this type of comparison is nearly meaningless. All of the leading theorists and researchers in the psychotherapeutic treatment of OCD (or at least the ones who attend AABT) advocate approaches which integrate cognitive interventions with behavioral interventions and maintain a strong emphasis on E&RP. (obviously this is a point on which I have strong opinions)
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