You do not currently have permission to view the full text for this document. Please sign in to an account with an active subscription or contact support.
This paper presents a review of the empirical literature on OCD, focusing on treatments developed on the basis of behavioral learning theories. Various behavioral approaches are discussed with a particular emphasis on their documented efficacy. Exposure treatments allow clients to face anxiety-provoking material, either directly or in imagination, and include procedures such as systematic desensitization, paradoxical intention, satiation/habituation, and in vivo or imaginal flooding. Blocking treatments stop clients' rituals through thought stopping, aversion therapy, distraction, and ritual prevention. OCD symptoms have responded well to these established behavioral treatments and even more dramatically to treatment strategies using a combination of direct exposure and ritual prevention. The combination treatment has shown considerable effectiveness and efficiency for a broad range of clients, yielding consistently positive results with a 65% to 85% improvement in mood and general functioning in addition to OCD symptoms. Empirical evidence suggests that combining exposure and ritual prevention can be readily transferrable from research laboratories to clinical settings. Also, this paper briefly compares behavioral therapy to treatment methods based on other
Dr. Lam is Adjunct Assistant Professor, Department of Psychiatry, University of California, San Francisco.
Dr. Steketee is Chair of Clinical Practice, Boston University School of Social Work.
theoretical orientations. Finally, this paper provides treatment guidelines to aid clinicians in planning and carrying out the treatment of combining exposure and ritual prevention with their clients.