Is CT an adjunct to ERP in treating OCD?

The preceeding discussion makes it sound as though Behavior Therapy and CBT use exposure and response prevention (ERP) in treating OCD but that CT does not. This is a common misconception. Somehow people get the impression that CT only uses cognitive interventions despite all that is written about the role of behavioral interventions in CT.

It is important to remember that CT is a cognitive-behavioral therapy and that behavioral interventions are an essential component of CT. A cognitive therapist who only uses cognitive interventions is neglecting an important part of CT.

It is not a matter of using CT as an adjunct to ERP, ERP is an essential component of CT with OCD. If one is using cognitive interventions with OCD and is not combining them with some form of behavioral exposure (such as ERP), then one is not doing CT.

Behavioral exposure is an essential component of CT with all of the anxiety disorders. Rational responses alone are not effective in reducing anxiety, behavioral exposure is needed to reduce the anxiety. This does not mean that cognitive interventions are unimportant... they are an important part of getting clients to follow through on the ERP.

In treating OCD it is not a matter of the cognitive interventions being an adjunct to ERP or a matter of ERP being an adjunct to cognitive interventions. The two need to be used in combination.

Replies:

More on the role of ERP in CT for OCD, by Jim Pretzer, 10/05/03

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