BT vs. CT

I agree that CT without BT will have limited results. Yet, I wouldn't refer to the cognitive component as "adjunctive"; the cognitive and meta-cognitive interventions provide an essential framework for helping the client to commit to the necessary exposure work and to tolerate the resultant distress.

Habituation and extinction are the fundamental processes at the core of recovery from OCD and other anxiety disorders.

Phillipson writes:

"Cognitive therapy strategies are ineffective substitutes for the behavioral assignments (i.e. exposure and response prevention), which are paramount in bringing about therapeutic benefits. The immediate goal of therapy is not to eliminate the spikes or to feel better. The techniques are designed to manage anxiety and to stop the endless cycle of ritualizing. The long-term indirect dividends of these strategies are to reduce the spike frequency and to reduce the frequency and intensity of the associated anxiety."

see www.ocdonline.com

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