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Behavior Therapy and OCD
Traditional psychotherapy, is generally not helpful for Obsessive Compulsive Disorder (OCD). However, a specific behavior therapy approach called "exposure and response prevention" is effective for many people with OCD.
In this approach, the patient deliberately and voluntarily confronts the feared object or idea, either directly or by imagination. At the same time the patient is strongly encouraged to refrain from performing the normal ritual, with support and structure provided by the mental health therapist, and possibly by a friend or family member chosen as a recruit by the patient. For example, a compulsive hand washer may be encouraged to touch an object believed to be contaminated, and then urged to avoid washing for several hours until the anxiety provoked has greatly decreased. Treatment then proceeds on a step-by-step basis, guided by the patient's ability to tolerate the anxiety and control the rituals. As treatment progresses, most patients gradually experience less anxiety from the obsessive thoughts and are able to resist the compulsive urges.
Studies of behavior therapy for OCD have found it to be a successful treatment for the majority of patients who complete it. For the treatment to be successful, it is important that the therapist be fully trained to provide this specific form of therapy and it is also very important for the patient to be highly motivated with a positive and determined attitude.
The positive effects of behavior therapy endure once treatment has ended. A recent compilation of outcome studies indicated that, of more than 300 Obsessive Compulsive Disorder patients who were treated by exposure and response prevention, an average of 76 percent still showed clinically significant relief from 3 months to 6 years after treatment. Another study has found that incorporating relapse-prevention components in the treatment program, including follow-up sessions after the intensive therapy, contributes to the maintenance of improvement.
One study provides new evidence that cognitive-behavioral therapy may also prove effective for Obsessive Compulsive Disorder. This variant of behavior therapy emphasizes changing the individual's beliefs and thinking patterns. Additional studies are required before the promise of cognitive-behavioral therapy can be adequately evaluated. The ongoing search for causes, together with research on treatment, promises to yield even more hope for people with Obsessive Compulsive Disorder (OCD) and their families.
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