CBT

• what is CBT?

  normally first choice for treatment of OCD, recommended by NICE. goal oriented and quick, running for 3 months.

  • 2 components: changing thought process (cognitive) and changing actions (behavioural)
• how does cognitive therapy work for CBT?

  encouraged to test beliefs

  • cognitive distortion of catastrophising. person predicts negative outcome and jumps to conclusion that if the negative outcome did happen it would be a catastrophe
  • habituation training. client is asked to think about obsessive thoughts which will be less anxiety provoking

  therapy focuses on helping obsessions
• how does behavioural therapy work for CBT?

  exposure and response prevention therapy, focuses on compulsions and deliberately exposes clients to situations that cause anxiety. requires resistance of going through compulsion.
• 3 steps involved in ERPT?

  • informing client about exposure and response prevention, what the therapy will involve.
  • using exposure hierarchy, starts mildly anxiety-raising situations and goes through to the highest level of anxiety.
  • repeated exposure to situations that cause anxiety until it's reduced
  • getting the client to resist compulsions
• Franklin (2005)?

  clients after ERPT show that between 55-75% show improvement, which lasts 5 to 6 years.
• strengths of CBT?

  • no side effects seen
  • lower relapse rates than medication when discontinued
  • ethical form of treatment, patients taught techniques they can use on their own
• weakness of CBT?

  • POTS (2004), CBT is effective when compared to a placebo but is limited treatment which should be used in combination with other forms of therapy (sertraline and CBT better)
  • difficult to disentangle if CBT benefits are due to cognitive or behavioural component
• Overbeek (2002)?

  1/3 participants with OCD had clinical symptoms of depression, group showed less improvement when treated with ERP and drug treatment combination compared to a group with OCD only symptoms

  • although 70% respond well to CBT, therapy needs to be tailored to the needs of the particular person
• Masellis (2003)?

  up to 44% clients only suffer from obsessions, up to 75% had co-morbid depression which lessens effect of ERPT

  • ERPT isn't effective for those with no compulsions