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Overall, cognitive and behavioral therapies appear to be even more effective than medications in both adults and children with OCD. When appropriate, behavioral and cognitive therapy for OCD can be combined with medications for the best result.
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Behavioral Therapy
Although there are a variety of behavioral therapies fortreating OCD, most of these focus on exposing you to those things that you fear most. This exposure provides you with an opportunity to gain new information in hopes of disconfirming your worst fears.
Exposure and Response Prevention
How Long Does It Take?
ERP usually involves 15 to 20 exposure sessions that last about 90 minutes. These sessions usually take place at a therapist’s office, although you are usually asked to practice ERP at home.
Drawbacks
Although behavior therapy is highly effective for about two-thirds of people who complete treatment, there are drawbacks:
Cognitive Therapy
4 Things Your OCD Therapist Should Avoid in Treatment
Magical Thinking
If you have OCD, you might dramatically overestimate the degree to which you are responsible for a catastrophic event taking place and feel you have to take actions to prevent it. For instance, you might experience an uncontrollable urge to count or order a particular object to prevent a plane crash. Of course, counting or ordering a particular object couldn’t possibly have any impact on whether a plane crashes or not. This illogical thought pattern is often calledmagical thinking.
Cognitive therapy involves examining harmful thought patterns and coming up with plausible alternatives that are more realistic and less threatening. It is not uncommon to be unaware of some of the distortions present in your thinking, and the therapist may help to point these out.
Also, cognitive therapy often integrates elements of behavior therapy. For example, your therapist may have you test out some of the plausible alternatives you have come up with throughexposure therapy.
The 9 Best Online Therapy Programs
How Long Does It Take?
Like ERP, cognitive therapy is usually done over the course of 15 to 20 sessions, although the cognitive therapy sessions are often shorter in duration, lasting 50 to 60 minutes. As with ERP, you are often asked to do homework, which usually comprises of keeping a daily journal of your thoughts as well as keeping track of whether your worst fears actually came true.
Considerations
Deciding to engage in behavioral or cognitive therapy for OCD is a decision that should be made in consultation with your family doctor, psychiatrist, or psychologist as part of your overall treatment plan. In controlled research studies, behavioral and cognitive therapy seem to be equally effective. However, in practice, they are often combined for maximum effect. This is referred to ascognitive-behavior therapy.
No matter what type of therapy you choose to pursue, it’s most helpful when you actively engage in an open discussion with your doctor or mental health professional—one in which you are honest about your symptoms, feelings, thoughts, and anything else that comes to your mind. This will help to form a full picture of what you require to move forward and progress.
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Before engaging in psychotherapy, it may be helpful to ask yourself the following questions:
Get Help NowWe’ve tried, tested, and written unbiased reviews of thebest online therapy programsincluding Talkspace, BetterHelp, and ReGain. Find out which option is the best for you.
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We’ve tried, tested, and written unbiased reviews of thebest online therapy programsincluding Talkspace, BetterHelp, and ReGain. Find out which option is the best for you.
A Word From Verywell
Research shows that the people who have good results with psychotherapy are those who are highly motivated to change and willing to try and put in the commitment required.If you have questions about your readiness to participate in psychotherapy, talk to your doctor or psychologist.
If you do decide to includepsychotherapyas part of your overall treatment plan, make sure you are comfortable with your therapist. If you feel something is preventing you from having a good working relationship, don’t be afraid to bring it up in therapy. A good therapist will be happy that you have brought this to their attention and will try to work through these issues with you.
A Verywell Report: Americans Find Strength in Online Therapy
Since online therapy (or telephone therapy) is becoming more common, researchers have analyzed whether this can be as effective as in-person therapy. So far, studies suggest that the answer is yes. But keep in mind that distant therapy is more difficult as both the client and therapist lack the ability to interpret body language and other factors. However, it is still a good option for those who live quite a distance from a good therapist.
Benefits of Group Cognitive Behavioral Therapy for OCD
7 SourcesVerywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Law C, Boisseau CL.Exposure and Response Prevention in the Treatment of Obsessive-Compulsive Disorder: Current Perspectives.Psychol Res Behav Manag. 2019;12:1167-1174. doi:10.2147/PRBM.S211117Nezu CM, Martell CR, Nezu AM.Specialty Competencies in Cognitive and Behavioral Psychology.Oxford University Press. 2013.Foa EB.Cognitive behavioral therapy of obsessive-compulsive disorder.Dialogues Clin Neurosci. 2010;12(2):199-207.Abramowitz JS, McKay D, Storch EA.The Wiley Handbook of Obsessive Compulsive Disorders.Wiley. 2017.Laforest M, Bouchard S, Bossé J, Mesly O.Effectiveness of In Virtuo Exposure and Response Prevention Treatment Using Cognitive-Behavioral Therapy for Obsessive-Compulsive Disorder: A Study Based on a Single-Case Study Protocol.Front Psychiatry. 2016;7:99. doi:10.3389/fpsyt.2016.00099Ryan RM, Lynch MF, et al.Motivation and Autonomy in Counseling, Psychotherapy, and Behavior Change: A Look at Theory and Practice.The Counseling Psychologist. 2011;39(2):193–260. doi:10.1177/0011000009359313Wootton BM.Remote cognitive-behavior therapy for obsessive-compulsive symptoms: A meta-analysis.Clin Psychol Rev. 2016;43:103-13. doi:10.1016/j.cpr.2015.10.001Additional ReadingOst, L., Havnen, A., Hansen, B., and G. Kvale.Cognitive Behavioral Treatments of Obsessive-compulsive Disorder. A Systematic Review and Meta-analysis of Studies Published 1993-2014Clinical Psychology Review. 2015. 40:156-69.Ost, L., Riise, E., Wergeland, G., Hansen, B., and G. Kvale.Cognitive Behavioral and Pharmacological Treatments of OCD in Children: A Systematic Review and Meta-Analysis.Journal of Anxiety Disorders. 2016. 43:58-69.Wootton, B.Remote Cognitive-Behavior Therapy for Obsessive-Compulsive Symptoms: A Meta-Analysis.Clinical Psychology Review. 2016. 43:103-13.
7 Sources
Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Law C, Boisseau CL.Exposure and Response Prevention in the Treatment of Obsessive-Compulsive Disorder: Current Perspectives.Psychol Res Behav Manag. 2019;12:1167-1174. doi:10.2147/PRBM.S211117Nezu CM, Martell CR, Nezu AM.Specialty Competencies in Cognitive and Behavioral Psychology.Oxford University Press. 2013.Foa EB.Cognitive behavioral therapy of obsessive-compulsive disorder.Dialogues Clin Neurosci. 2010;12(2):199-207.Abramowitz JS, McKay D, Storch EA.The Wiley Handbook of Obsessive Compulsive Disorders.Wiley. 2017.Laforest M, Bouchard S, Bossé J, Mesly O.Effectiveness of In Virtuo Exposure and Response Prevention Treatment Using Cognitive-Behavioral Therapy for Obsessive-Compulsive Disorder: A Study Based on a Single-Case Study Protocol.Front Psychiatry. 2016;7:99. doi:10.3389/fpsyt.2016.00099Ryan RM, Lynch MF, et al.Motivation and Autonomy in Counseling, Psychotherapy, and Behavior Change: A Look at Theory and Practice.The Counseling Psychologist. 2011;39(2):193–260. doi:10.1177/0011000009359313Wootton BM.Remote cognitive-behavior therapy for obsessive-compulsive symptoms: A meta-analysis.Clin Psychol Rev. 2016;43:103-13. doi:10.1016/j.cpr.2015.10.001Additional ReadingOst, L., Havnen, A., Hansen, B., and G. Kvale.Cognitive Behavioral Treatments of Obsessive-compulsive Disorder. A Systematic Review and Meta-analysis of Studies Published 1993-2014Clinical Psychology Review. 2015. 40:156-69.Ost, L., Riise, E., Wergeland, G., Hansen, B., and G. Kvale.Cognitive Behavioral and Pharmacological Treatments of OCD in Children: A Systematic Review and Meta-Analysis.Journal of Anxiety Disorders. 2016. 43:58-69.Wootton, B.Remote Cognitive-Behavior Therapy for Obsessive-Compulsive Symptoms: A Meta-Analysis.Clinical Psychology Review. 2016. 43:103-13.
Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Law C, Boisseau CL.Exposure and Response Prevention in the Treatment of Obsessive-Compulsive Disorder: Current Perspectives.Psychol Res Behav Manag. 2019;12:1167-1174. doi:10.2147/PRBM.S211117Nezu CM, Martell CR, Nezu AM.Specialty Competencies in Cognitive and Behavioral Psychology.Oxford University Press. 2013.Foa EB.Cognitive behavioral therapy of obsessive-compulsive disorder.Dialogues Clin Neurosci. 2010;12(2):199-207.Abramowitz JS, McKay D, Storch EA.The Wiley Handbook of Obsessive Compulsive Disorders.Wiley. 2017.Laforest M, Bouchard S, Bossé J, Mesly O.Effectiveness of In Virtuo Exposure and Response Prevention Treatment Using Cognitive-Behavioral Therapy for Obsessive-Compulsive Disorder: A Study Based on a Single-Case Study Protocol.Front Psychiatry. 2016;7:99. doi:10.3389/fpsyt.2016.00099Ryan RM, Lynch MF, et al.Motivation and Autonomy in Counseling, Psychotherapy, and Behavior Change: A Look at Theory and Practice.The Counseling Psychologist. 2011;39(2):193–260. doi:10.1177/0011000009359313Wootton BM.Remote cognitive-behavior therapy for obsessive-compulsive symptoms: A meta-analysis.Clin Psychol Rev. 2016;43:103-13. doi:10.1016/j.cpr.2015.10.001
Law C, Boisseau CL.Exposure and Response Prevention in the Treatment of Obsessive-Compulsive Disorder: Current Perspectives.Psychol Res Behav Manag. 2019;12:1167-1174. doi:10.2147/PRBM.S211117
Nezu CM, Martell CR, Nezu AM.Specialty Competencies in Cognitive and Behavioral Psychology.Oxford University Press. 2013.
Foa EB.Cognitive behavioral therapy of obsessive-compulsive disorder.Dialogues Clin Neurosci. 2010;12(2):199-207.
Abramowitz JS, McKay D, Storch EA.The Wiley Handbook of Obsessive Compulsive Disorders.Wiley. 2017.
Laforest M, Bouchard S, Bossé J, Mesly O.Effectiveness of In Virtuo Exposure and Response Prevention Treatment Using Cognitive-Behavioral Therapy for Obsessive-Compulsive Disorder: A Study Based on a Single-Case Study Protocol.Front Psychiatry. 2016;7:99. doi:10.3389/fpsyt.2016.00099
Ryan RM, Lynch MF, et al.Motivation and Autonomy in Counseling, Psychotherapy, and Behavior Change: A Look at Theory and Practice.The Counseling Psychologist. 2011;39(2):193–260. doi:10.1177/0011000009359313
Wootton BM.Remote cognitive-behavior therapy for obsessive-compulsive symptoms: A meta-analysis.Clin Psychol Rev. 2016;43:103-13. doi:10.1016/j.cpr.2015.10.001
Ost, L., Havnen, A., Hansen, B., and G. Kvale.Cognitive Behavioral Treatments of Obsessive-compulsive Disorder. A Systematic Review and Meta-analysis of Studies Published 1993-2014Clinical Psychology Review. 2015. 40:156-69.Ost, L., Riise, E., Wergeland, G., Hansen, B., and G. Kvale.Cognitive Behavioral and Pharmacological Treatments of OCD in Children: A Systematic Review and Meta-Analysis.Journal of Anxiety Disorders. 2016. 43:58-69.Wootton, B.Remote Cognitive-Behavior Therapy for Obsessive-Compulsive Symptoms: A Meta-Analysis.Clinical Psychology Review. 2016. 43:103-13.
Ost, L., Havnen, A., Hansen, B., and G. Kvale.Cognitive Behavioral Treatments of Obsessive-compulsive Disorder. A Systematic Review and Meta-analysis of Studies Published 1993-2014Clinical Psychology Review. 2015. 40:156-69.
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