Cognitive therapy of obsessive thoughts Original Research Article

Six people with obsessive thoughts without overt compulsions received cognitive therapy based on a comprehensive cognitive-behavioral account of obsessive-compulsive behavior using techniques developed specifically for OCD (). They were treated within a multiple-baseline, experimental single-case design supplemented by a standardized assessment battery using both clinician assessment and self-report. The treatment targeted faulty beliefs specified by the model in a flexible manner based on a case-formulation approach. Participants did not receive instructions or practice in systematic exposure and response prevention. They were encouraged to act in a way that was coherent with their new understanding of obsessive thoughts. Participants received an average of 16.2 sessions of therapy. Follow-up assessment was conducted at 6 and 12 months following the end of treatment. Using a double criteria for clinically significant change, 4 participants (66%) were improved on the Yale-Brown Obsessive-Compulsive Scale at posttreatment, and 5 (83%) were improved at 6- and 12-month follow-up. These results indicate that alternative strategies to structured exposure and response prevention can be effective. The possibility of integrating structured exposure techniques within this treatment framework is discussed.