Obsessive Compulsive Disorder
Cognitive Biobehavioral Management
- Develop a MINDFUL awareness of the "thoughts" or "urges" as obsessions or compulsions.
- Develop and increase one's understanding that a neurobiological imbalance is causing the symptoms.
- One develops more ability to not take the thoughts or urges at face value.
- One develops more distance from the thoughts or urges.
Example: "It's not me, it's my OCD."
Refocus and Record
- Develop a program of self-directed response prevention.
- REFOCUS: Actively do another reasonable task or activity.
- Prevent a response to OCD symptoms.
- Pre-select the activity or task.
- Select it as a homework activity.
- RECORD: Write down the work in a diary.
- Boost confidence.
- Increase number of ways to refocus (tactical repertoire.
- 15 MINUTE RULE: Wait 15 minutes before giving in.
- Improve ability to go without giving in to thoughts or urges and applying:
- Mindful awareness.
- Reattribution as a pathological process.
- Interim Goals
Consider setting interim goals
- Impose a shorter time delay is used before a compulsion.
- Use refocusing every time with obsessive thoughts.
- Demonstrate it is not necessary to entirely eliminate thoughts in order to perform other activities.
- Demonstrate the value of repeated tries at refocusing.
- Place a lower valuation on the obsessions or compulsions during the later stage of treatment.
- Accentuation of the relabeling and reattribution.
- Increase habituation.
- The thoughts or urges decrease in intensity.
- The thoughts or urges become less bothersome.
- Reduction of effort to dismiss thoughts or urges.
- Positive and assertive revaluation statements intensify the refocusing process.
- Partial habituation indicates progress with the problem. It's a cue for making more effort at Steps 1 - 3.
The above methods of clinical treatment are adapted from the treatment methods described in the following reference: Schwartz, J.M., Martin, K.M., Baxter, L.R., Neuroimaging and cognitive-biobehavioral self-treatment for obsessive compulsive disorder: practical and philosophical considerations. In: Hand, I., Goodman, W.K., Evers, U., ed. (1992) Obsessive-Compulsive Disorders: New Research Results. New York: Springer-Verlag, p. 82-101.
Behavior therapy strategies | Cognitive-biobehavioral management | Medication strategies | Treatment Response |