A Review of Psychotherapy for Obsessive-Compulsive Disorder

Introduction

Obsessive-compulsive disorder (OCD) has a point-prevalence of approximately 1%–2% across children and adults1–3 and a lifetime prevalence of approximately 2% 4 Obsessive-compulsive disorder is characterized by the presence of distressing and difficult to control thoughts, impulses, or images that evoke considerable distress (obsessions). Individuals with OCD tend to engage in overt or covert behaviors aimed to reduce or neutralize distress (compulsions). Problematically, this cycle of compulsion engagement in response to obsessional triggers creates a negative reinforcement loop (ie, rituals reduce anxiety in the short-term), which maintains and/or exacerbates symptom severity.5

Abstract

Cognitive-behavioral therapy (CBT) is a first-line treatment for obsessive-compulsive disorder (OCD) in adults and children due to its efficacy, maintenance of therapeutic gains after treatment withdrawal, safety, and tolerability. The current article reviews research regarding the theoretical underpinnings of CBT, pragmatics regarding CBT implementation, and efficacy findings, while also highlighting barriers to efficacious treatment (ie, age, comorbidity, geography), methods of addressing such issues, and areas in need of further study.

Keywords

cognitive-behavioral therapy, obsessive-compulsive disorder, treatment, psychotherapy