Treatment of Obsessive Thoughts and Cognitive Rituals Using Exposure and Response Prevention

Abstract

This case study describes the application of cognitive-behavioral therapy by exposure and response prevention (EX/RP) to a young man with obsessive-compulsive disorder (OCD) involving primarily obsessional thoughts and mental rituals. Although patients with primarily cognitive OCD symptoms have been previously considered treatment resistant, novel approaches to EX/RP have been developed and validated. Successful treatment of such symptoms requires a thorough and informed assessment. The theoretical and empirical basis for these procedures is described, along with a cognitive-behavioral analysis of the problem. The course of treatment, use of assessment data, and recommendations to clinicians are also discussed.