Working with interpretations in cognitive behavioural therapy for obsessive compulsive disorder

Abstract

Cognitive behavioural therapy (CBT) is a highly effective treatment for obsessive compulsive disorder (OCD). Identifying, challenging and monitoring interpretations of intrusions is considered a key element of CBT for OCD but preliminary research suggests that treatment does not always include identification and modification of misinterpretations. The present investigation explored ‘OCD-expert’ and ‘non-OCD-expert’ clinicians’ views on key elements of CBT for OCD to determine whether identifying and modifying key interpretations were considered important in therapy and whether clinicians who do not have specific expertise in OCD found working with interpretations difficult. Study 1 used a qualitative approach to investigate OCD-expert and non-OCD-expert clinician's views on key elements of CBT for OCD. Study 2 used a questionnaire to investigate what non-OCD-expert clinicians viewed as important and difficult aspects of CBT for OCD. Study 1 results showed that OCD-expert and non-OCD-expert clinicians reported working with interpretations was a key element of CBT for OCD. However, OCD-expert clinicians linked interpretations more closely to a formulation and intervention plan and reported using more techniques and questionnaires when working with interpretations compared with non-OCD-expert clinicians. Study 2 results showed that non-OCD-expert clinicians rated interpretations as both important and difficult to work with but no more important or difficult than other key elements of CBT for OCD. OCD-expert and non-OCD-expert clinicians identify working with interpretations as a key element of CBT for OCD. Non-OCD-expert clinicians may benefit from additional training on formulation tools that help identify, monitor and challenge interpretations of intrusions.