A well-established, highly effective, and lasting treatment is called Cognitive-Behavioral Therapy, or CBT. It focuses on identifying, understanding, and changing thinking and behavior patterns. Benefits are usually seen in 12 to 16 weeks, depending on the individual.
In this type of therapy the patient is actively involved in his or her own recovery, has a sense of control, and learns skills that are useful throughout life. CBT typically involves reading about the problem, keeping records between appointments, and completing homework assignments in which the treatment procedures are practiced. Patients learn skills during therapy sessions, but they must practice repeatedly to see improvement. The most important therapy in CBT for OCD is called “Exposure/ and Response Prevention” (E/RP).
A form of CBT, exposure/response prevention (E/RP) therapy is a process for reducing fear and anxiety responses.
The “Exposure” in E/RP refers to confronting the thoughts, images, objects and situations that make a person with OCD anxious.
The “Response Prevention” in E/RP refers to making a choice not to do a compulsive behavior after coming into contact with the things that make a person with OCD anxious.
This strategy may not sound right to most people. Those with OCD have probably confronted their obsessions many times and tried to stop themselves from doing their compulsive behavior, only to see their anxiety skyrocket. With E/RP, a person has to make the commitment to not give in and do the compulsive behavior until they notice a drop in their anxiety. In fact, it is best if the person stays committed to not doing the compulsive behavior at all. The natural drop in anxiety that happens when you stay “exposed” and “prevent” the “response” is called habituation.
Habit Reversal Training (HRT) is a behavioral intervention that is effective in reducing tics and other so-called impulse control disorders such as skin picking and trichotillomania (hair pulling). In HRT, individuals are first taught to increase their awareness of their symptoms through self-monitoring and other activities. Once awareness is increased, the therapist helps the client to choose and implement an alternate response that takes the place of the symptom. Support, encouragement, and motivation building are woven into the sessions as the client works on these skills.
For more information about these disorders visit www.adaa.org.