Abstract
Cognitive-behavioral therapy (CBT) with exposure and response prevention is a first-line intervention for adult and childhood obsessive-compulsive disorder. Methodologically rigorous controlled trials have suggested that benefits from CBT exceed those from placebo and attention-control conditions and have similar or greater efficacy than serotonergic monotherapy. This article reviews the nature of CBT and associated outcome data, highlighting recent empiric findings in the treatment literature.
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References and Recommended Reading
Abramowitz JS, Whiteside SP, Deacon BJ: The effectiveness of treatment for pediatric obsessive-compulsive disorder. Behav Ther 2005, 36:55–63.
Pediatric OCD Treatment Study (POTS) Team: Cognitivebehavior therapy, sertraline, and their combination for children and adolescents with obsessive-compulsive disorder: the Pediatric OCD Treatment Study (POTS) randomized controlled trial. JAMA 2004, 292:1969–1976.
Foa EB, Liebowitz MR, Kozak MJ, et al.: Randomized, placebo-controlled trial of exposure and ritual prevention, clomipramine, and their combination in the treatment of obsessive-compulsive disorder. Am J Psychiatry 2005, 162:151–161.
Barlow DH: Anxiety and its Disorders. New York: Guilford Press; 1988.
Clark DM: A cognitive approach to panic. Behav Res Ther 1986, 24:461–470.
Rapee RM, Heimberg RG: A cognitive-behavioral model of anxiety in social phobia. Behav Res Ther 1997, 35:741–756.
Foa EB, Kozak MJ: Treatment of anxiety disorders: implications for psychopathology. In Anxiety and the Anxiety Disorders. Edited by Tuma AH, Maser JD. Mahwah, NJ: Lawrence Erlbaum Associates; 1985:421–452.
Salkovskis PM: Obsessional-compulsive problems: a cognitivebehavioural analysis. Behav Res Ther 1985, 23:571–583.
March JS, Franklin M, Nelson A, Foa E: Cognitive-behavioral psychotherapy for pediatric obsessive-compulsive disorder. J Clin Child Psychol 2001, 30:8–18.
Barrett PD, Farrell L, Pina AA, et al.: Evidence-based psychosocial treatments for child and adolescent obsessive-compulsive disorder. J Clin Child Adolesc Psychol 2008, 37:131–155.
Franklin ME, Foa EB: Cognitive-behavioral treatments for obsessive-compulsive disorder. In A Guide to Treatments That Work. Edited by Nathan PE, Gorman JM. London: Oxford University Press; 2002:367–386.
American Academy of Child and Adolescent Psychiatry (AACAP): Practice parameters for the assessment and treatment of children and adolescents with obsessive-compulsive disorder. J Am Acad Child Adolesc Psychiatry 1998, 37:527–545.
Foa EB, Kozak MJ: Psychological treatments for obsessivecompulsive disorder. In Long-term Treatments of Anxiety Disorders. Edited by Mavissakalian MR, Prien RF. Washington, DC: American Psychiatric Association; 1996:285–309.
Franklin ME, Abramowitz JS, Kozak MJ, et al.: Effectiveness of exposure and ritual prevention for obsessive-compulsive disorder: randomized compared with nonrandomized samples. J Consult Clin Psychol 2000, 68:594–602.
Black DW: Efficacy of combined pharmacotherapy and psychotherapy versus monotherapy in the treatment of anxiety disorders. CNS Spect 2006, 11(10 Suppl 12):29–33.
March JS, Benton CM: Talking Back to OCD: The Program That Helps Kids and Teens Say “No Way”—and Parents Say “Way to Go.” New York: Guilford Press; 2007.
Valderhaug R, Larsson B, Gotestam KG, Piacentini J: An open clinical trial of cognitive-behaviour therapy in children and adolescents with obsessive-compulsive disorder administered in regular outpatient clinics. Behav Res Ther 2007, 45:577–589.
Abramowitz JS, Foa EB, Franklin ME: Exposure and ritual prevention for obsessive-compulsive disorder: effectiveness of intensive versus twice-weekly treatment sessions. J Consult Clin Psychol 2003, 71:394–398.
Franklin ME, Kozak MJ, Cashman LA, et al.: Cognitivebehavioral treatment of pediatric obsessive-compulsive disorder: an open clinical trial. J Am Acad Child Adolesc Psychiatry 1998, 37:412–419.
Storch EA, Geffken GR, Merlo LJ, et al.: Family-based cognitive-therapy for pediatric obsessive-compulsive disorder: comparison of intensive and weekly approaches. J Am Acad Child Adolesc Psychiatry 2007, 46:469–478.
Foa EB, Franklin ME, Kozak MJ: Psychosocial treatment of obsessive-compulsive disorder: literature review. In Obsessive-Compulsive Disorder: Theory, Research, and Treatment. Edited by Swinson RP, Antony MM, Rachman S, Richter MA. New York: Guilford Press; 1998:258–276.
Salkovskis PM, Forrester E, Richards C: Cognitivebehavioural approach to understanding obsessional thinking. Br J Psychiatry 1998, 173:53–66.
Krochmalik A, Jones MK, Menzies RG: Danger ideation reduction therapy (DIRT) for treatment-resistant compulsive washing. Behav Res Ther 2001, 39:897–912.
van Oppen P, de Haan E, van Balkom A, et al.: Cognitive therapy and exposure in vivo in the treatment of obsessive compulsive disorder. Behav Res Ther 1995, 33:379–390.
Wilhelm S, Steketee G, Reilly-Harrington NA, et al.: Effectiveness of cognitive therapy for obsessive-compulsive disorder: an open trial. J Cogn Psychother 2005, 19:173–179.
Wilson KA, Chambless DL: Cognitive therapy for obsessivecompulsive disorder. Behav Res Ther 2005, 43:1645–1654.
Freeman JB, Garcia AM, Coyne L, et al.: Early childhood OCD: preliminary findings from a family-based cognitive-behavioral approach. J Am Acad Child Adolesc Psychiatry 2008, 47:593–602.
Barrett P, Healy-Farrell L, March JS: Cognitive-behavioral treatment of childhood obsessive-compulsive disorder: a controlled trial. J Am Acad Child Adolesc Psychiatry 2004, 43:46–62.
Whiteside SP, Brown AM, Abramowitz JS: Five-day intensive treatment for adolescent OCD: a case series. J Anxiety Disord 2008, 22:495–504.
Rowa K, Antony MM, Summerfeldt LJ, et al.: Office-based vs. home-based behavioral treatment for obsessive-compulsive disorder: a preliminary study. Behav Res Ther 2007, 45:1883–1892.
Tolin DF, Hannan S, Maltby N, et al.: A randomized controlled trial of self-directed versus therapist-directed cognitive-behavioral therapy for obsessive-compulsive disorder patients with prior medication trials. Behav Ther 2007, 38:179–191.
Anderson RA, Rees CS: Group versus individual cognitivebehavioural treatment for obsessive-compulsive disorder: a controlled trial. Behav Res Ther 2007, 45:123–137.
Ginsberg GS, Kingery JN, Drake KL, Grados MA: Predictors of treatment response in pediatric obsessive-compulsive disorder. J Am Acad Child Adolesc Psychiatry 2008, 47:868–878.
Storch EA, Merlo LJ, Larson MJ, et al.: Impact of comorbidity on cognitive-behavioral therapy response in pediatric obsessive-compulsive disorder. J Am Acad Child Adolesc Psychiatry 2008, 47:583–592.
Hansen B, Vogel PA, Stiles TC, Götestam KG: Influence of co-morbid generalized anxiety disorder, panic disorder and personality disorders on the outcome of cognitive behavioural treatment of obsessive-compulsive disorder. Cogn Behav Ther 2007, 36:145–155.
Storch EA, Merlo LJ, Larson MJ, et al.: Symptom dimensions and cognitive-behavioural therapy outcome for pediatric obsessive-compulsive disorder. Acta Psychiatr Scand 2008, 117:67–75.
Diefenbach GJ, Abramowitz JS, Norberg MM, Tolin DF: Changes in quality of life following cognitive-behavioral therapy for obsessive-compulsive disorder. Behav Res Ther 2007, 45:3060–3068.
Storch EA, Murphy TK, Lack CW, et al.: Sleep-related problems in pediatric obsessive-compulsive disorder. J Anxiety Disord 2008, 22:877–885.
Walker DL, Ressler KJ, Lu KT, Davis M: Facilitation of conditioned fear extinction by systemic administration or intra-amygdala infusions of D-cycloserine as assessed with fear-potentiated startle in rats. J Neurosci 2002, 22:2343–2351.
Ledgerwood L, Richardson R, Cranney J: Effects of D-cycloserine on extinction of conditioned freezing. Behav Neurosci 2003, 117:341–349.
Ledgerwood L, Richardson R, Cranney J: D-cycloserine and the facilitation of extinction of conditioned fear: consequences for reinstatement. Behav Neurosci 2004, 118:505–513.
Ledgerwood L, Richardson R, Cranney J: D-cycloserine facilitates extinction of learned fear: effects on reacquisition and generalized extinction. Biol Psychiatry 2005, 57:841–847.
Ressler KJ, Rothbaum BO, Tannenbaum L, et al.: Cognitive enhancers as adjuncts to psychotherapy: use of D-cycloserine in phobic individuals to facilitate extinction of fear. Arch Gen Psychiatry 2004, 61:1136–1144.
Hofmann SG, Pollack MH, Otto MW: Augmentation treatment of psychotherapy for anxiety disorders with D-cycloserine. CNS Drug Rev 2006, 12:208–217.
Wilhelm S, Buhlmann U, Tolin DF, et al.: Augmentation of behavior therapy with D-cycloserine for obsessive-compulsive disorder. Am J Psychiatry 2008, 165:335–341.
Kushner MG, Kim SW, Donahue C, et al.: D-cycloserine augmented exposure therapy for obsessive-compulsive disorder. Biol Psychiatry 2007, 62:835–838.
Storch EA, Merlo LJ, Bengtson M, et al.: D-cycloserine does not enhance exposure-response prevention therapy in obsessive-compulsive disorder. Int Clin Psychopharmacol 2007, 22:230–237.
Simpson HB, Foa EB, Liebowitz MR, et al.: A randomized, controlled trial of cognitive-behavioral therapy for augmenting pharmacotherapy in obsessive-compulsive disorder. Am J Psychiatry 2008, 165:621–630.
Simpson HB, Zuckoff A, Page JR, et al.: Adding motivational interviewing to exposure and ritual prevention for obsessive-compulsive disorder: an open pilot trial. Cogn Behav Ther 2008, 37:38–49.
Tolin DF, Maltby N, Diefenbach GJ, et al.: Cognitivebehavioral therapy for medication nonresponders with obsessive-compulsive disorder: a wait-list-controlled open trial. J Clin Psychiatry 2004, 65:922–931.
Fritzler BK, Hecker JE, Losee MC: Self-directed treatment with minimal therapist contact: preliminary findings for obsessive-compulsive disorder. Behav Res Ther 1997, 35:627–631.
Tolin DF, Diefenbach GJ, Maltby N, Hannan SE: Stepped care for obsessive-compulsive disorder: a pilot study. Cogn Behav Pract 2005, 12:403–414.
Greist JH, Marks IM, Baer L, et al.: Behavior therapy for obsessive-compulsive disorder guided by a computer or by a clinician compared with relaxation as a control. J Clin Psychiatry 2002, 63:138–145.
Tolin DF, Hannan S, Maltby N, et al.: A randomized controlled trial of self-directed versus therapist-directed cognitive-behavioral therapy for obsessive-compulsive disorder patients with prior medication trials. Behav Ther 2007, 38:179–191.
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Storch, E.A., Mariaskin, A. & Murphy, T.K. Psychotherapy for obsessive-compulsive disorder. Curr Psychiatry Rep 11, 296–301 (2009). https://doi.org/10.1007/s11920-009-0043-8
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DOI: https://doi.org/10.1007/s11920-009-0043-8