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When Exposures Go Right: Effective Exposure-Based Treatment for Obsessive–Compulsive Disorder

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Abstract

Cognitive behavioral therapy with exposure and response prevention (CBT-E/RP) is the first-line treatment for obsessive–compulsive disorder (OCD). Several CBT-E/RP treatment manuals exist, yet clinicians still struggle to implement this evidence-based form of therapy. This article aims to help clinicians implement exposure-based treatment for OCD by providing practical treatment-enhancing strategies. In particular, literature and treatment recommendations related to effective hierarchy formation, strategic exposure design, and optimal exposure implementation is reviewed. Clinical case examples are provided throughout the paper to illustrate important principles, concepts, and recommendations. This paper aims to enhance the delivery of CBT-E/RP and address common questions and concerns that both new and advanced clinicians encounter when learning and applying this form of psychotherapy. Improving the integrity of CBT-E/RP delivery can improve therapeutic outcomes, patient compliance, and successful treatment completion.

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Authors and Affiliations

  1. St. Elizabeth Boardman Hospital, Family Health Center, 8423 Market St. Ste. 101, Boardman, OH, 44512, USA

    Cary Jordan

  2. Family and Community Medicine, Northeast Ohio Medical University, Rootstown, OH, USA

    Cary Jordan

  3. Department of Psychiatry, Harvard Medical School, Boston, MA, USA

    Adam M. Reid

  4. Division of Medical Psychology, Department of Psychiatry, University of Florida, 8491 NW 39th Ave, Gainesville, FL, 32606, USA

    Adam M. Reid & Andrew G. Guzick

  5. Rogers Behavioral Health-Nashville, 4230 Harding Pike, Nashville, TN, 37205, USA

    Jessica Simmons

  6. Department of Disability and Psychoeducational Studies, College of Education, University of Arizona, 1430 East 2nd St., Tuscon, AZ, 85721-0069, USA

    Michael L. Sulkowski

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  1. Cary Jordan
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  2. Adam M. Reid
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  3. Andrew G. Guzick
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  4. Jessica Simmons
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  5. Michael L. Sulkowski
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Correspondence to Cary Jordan.

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Author Cary Jordan, Adam Reid, Jessica Simmons and Michael Sulkowski authors declare they have no conflicts of interest.

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This article does not contain any studies with human participants or animals performed by any of the authors.

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Jordan, C., Reid, A.M., Guzick, A.G. et al. When Exposures Go Right: Effective Exposure-Based Treatment for Obsessive–Compulsive Disorder. J Contemp Psychother 47, 31–39 (2017). https://doi.org/10.1007/s10879-016-9339-2

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  • DOI: https://doi.org/10.1007/s10879-016-9339-2

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