This document discusses psychological therapies for obsessive-compulsive disorder (OCD), including exposure and response prevention (ERP) therapy and cognitive-behavioral therapy. ERP therapy involves exposing patients to anxiety-provoking stimuli while preventing compulsive rituals to help them learn anxiety can be reduced without rituals. Cognitive-behavioral therapy identifies and challenges irrational thoughts to modify dysfunctional beliefs and behaviors. Both therapies aim to "unlearn" conditioned obsessive and compulsive behaviors through reconditioning or cognitive restructuring.

1. Psychopathology:
Psychological therapies for OCD

2. Behavioural therapy –
1) Exposure and Response Prevention (ERP) therapy

ERP is about reconditioning.

Exposure – forcing the patient to
experience the stimulus and
learn, through association with
relaxation, that it no longer
produces anxiety.
Both obsessions and compulsions
have been acquired through
conditioning.

In order to recover, patients must
‘unlearn’ this behaviour.

Obsessions are maintained through
negative reinforcement.

Compulsive rituals have become
assosiated with anxiety reduction.
It consists of two components:



Response prevention – at the
same time the patient is also
prevented from engaging in their
usual compulsive rituals. The
patient must learn that anxiety
can be reduced without the
compulsive ritual.

3. Behavioural therapy – Exposure and Response
Prevention (ERP) therapy
Mode of action:




Psychiatrist identifies list of
target symptoms using YBOCS
List of items ranked by
patient from least to most
anxiety provoking.
13-20 weekly sessions
(average)
Sometimes monthly
booster sessions set up to
prevent relapse.

4. http://www.youtube.com/
watch?v=wvodgCQ5F-0

5. 2) Cognitive-behavioural therapy

Our behaviour is the product of
our thoughts, therefore we
should first of all address the
thoughts.

E.g. ‘I must switch this light on
and off 23 times or something
terrible will happen to me or my
family.’

This irrational thought will be
challenged and a patient will be
required to practise certain
optimistic statements which
challenge their cognitions.

Cognitive therapies focus on
changing thoughts, in contrast to
behavioural therapies which focus
on changing behaviour.

Aims to identify, challenge and
modify dysfunctional beliefs and
the behaviours that these will
result in.

Cognitive therapists believe that
the behaviourists overlook and
ignore the influences of a person’s
thinking on psychological
disorders.

6. Cognitive-behavioural therapy
Typical dysfunctional beliefs
You will now be given an
activity which will enable you to:



1) understand more about these
two therapies
2) evaluate them.
1) Unrealistic responsibility
appraisals – see themselves as
solely responsible for prevention of
negative outcomes to themselves or
those they love.

Over-importance of thoughts
– sufferer may feel that having a
thought (e.g. someone dying) will
mean it will happen.

Exaggerated perception of
threat – irrational belief in harmful
outcomes.

7. http://www.youtube.com/
watch?v=wvodgCQ5F-0

8. Task:

Make a leaflet to be given to patients explaining
to them one of the following two therapies for
OCD:

Behavioural (ERP)
Cognitive


9. Task continued….




Make sure you explain to the client exactly what
will happen to them during the therapy. Perhaps
include pictures.
Explain the likely strengths of this therapy.
Explain any possible problems with this therapy.
You have one lesson to get this ready.

10. Task continued….




Make sure you explain to the client exactly what
will happen to them during the therapy. Perhaps
include pictures.
Explain the likely strengths of this therapy.
Explain any possible problems with this therapy.
You have one lesson to get this ready.