Enhancing Exposure and Response Prevention for OCD

Abstract

The effectiveness of individual therapy by exposure and response prevention (ERP) for obsessive-compulsive disorder (OCD) is well established, yet not all patients respond well, and some show relapse on discontinuation. This article begins by providing an overview of the personal and interpersonal experiences of OCD, focusing on interpersonal processes that maintain OCD symptoms and interfere with ERP. The study then describes a couple-based treatment program that the authors have developed to enhance ERP for individuals with OCD who are in long-term relationships. This program involves psychoeducation, partner-assisted exposure therapy, couple-based interventions aimed at changing maladaptive relationship patterns regarding OCD (i.e., symptom accommodation), and general couple therapy. Three case examples are presented to illustrate the couple-based techniques used in this treatment program.

CBT for Body Dysmorphic Disorder by Proxy: A Case Study

“…Furthermore, although a couple's perspective on BDD by proxy has not been described, lessons may be learned from a similar approach to OCD. Recently, the interpersonal aspects of the latter disorder have been incorporated in a therapeutic approach (Abramowitz et al, 2013). In OCD as well as in BDD by proxy, the partner may get involved in what these authors call "symptom accommodation."…”

A pilot randomized controlled trial of videoconference-assisted treatment for obsessive-compulsive disorder

“…Some of the advantages of tablet-based VCT over face-to-face include easier access to family members to address family accommodation issues (Abramowitz et al, 2013). The flexibility of VCT reduces the need to miss work to attend sessions which can contribute to treatment interference in face-to-face therapy.…”

Strategies for Improving Long-Term Outcomes in Cognitive Behavioral Therapy for Obsessive-Compulsive Disorder: Insights From Learning Theory

“…In couples where one partner has OCD, the other partner is often drawn into providing reassurance (e.g., answering questions, providing assurances of safety for the OCD partner). We have developed a couple-based CBT program for OCD in which we work with both partners to address this safety behavior as a team (Abramowitz et al, 2013). Partners also learn about the importance of learning to tolerate anxiety, rather than trying to relieve it immediately.…”