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Other Treatments for Obsessive-Compulsive Disorder (OCD)
Treatment of obsessive-compulsive disorder (OCD) is tailored to meet your particular needs.
Behavior therapy can help you modify and gain control over your behavior. A technique called exposure and response prevention (ERP) is especially helpful in treating symptoms of OCD. With this approach, you are deliberately and voluntarily exposed to feared objects or ideas, either directly or by imagination. Then, with your permission, you are discouraged or prevented from carrying out your typical compulsive behavior.
For example, if you are a compulsive hand washer, you may be asked to touch an object that you believe to be contaminated and then denied the ability to wash for several hours. If the treatment works, you will gradually experience less anxiety from your obsessive thoughts and you will be able to refrain from compulsive behaviors for progressively longer periods of time.
Behavior therapy has been found to have lasting benefits. The best results occur if the following conditions are met:
- The therapist is well trained in the particular behavior therapy that is used.
- You are highly motivated.
- Your family (if involved) is cooperative.
- You attend sessions regularly.
- You finish homework assignments and complete the course of treatment.
Most psychiatrists and behavior therapists believe that a combination of behavior therapy (consisting of ERP) and medication is the most effective approach to treating OCD. For example, in a study published in the American Journal of Psychiatry, researchers found that people who took selective serotonin reuptake inhibitors (SSRIs) and participated in ERP had a greater reduction in symptoms, compared to those who took SSRIs and participated in stress management training.
Cognitive therapy helps you change patterns of thinking that are unproductive and harmful. This kind of therapy helps you examine your feelings and separate realistic from unrealistic thoughts or helpful from unhelpful thoughts. Like behavior therapy, cognitive therapy helps you gain a better sense of control over your life.
Cognitive Behavioral Therapy (CBT)
CBT is a combination of cognitive and behavior therapy. With this type of therapy, you examine your feelings and thought patterns, learn to interpret them in a more realistic way, and apply behavioral strategies.
Examples of therapies used to treat OCD include:
- Exposure and response prevention—involves gradually confronting the feared object or obsession without giving into the compulsive ritual linked to it
- Aversion therapy—involves using a painful stimulus to prevent OCD behavior
- Thought switching—involves learning to replace negative thoughts with positive thoughts
- Flooding—involves being exposed to object that causes OCD behavior
- Implosion therapy—involves being repeatedly exposed to object that causes fear
- Thought stopping—involves learning how to stop negative thoughts
If other treatments are not working, you and your doctor may consider electroconvulsive therapy (ECT). ECT has shown some success in those who have difficulty managing OCD. It involves sending an electronic current through the brain. This current causes brief seizure activity, which changes brain chemistry. However, ECT is not for everyone. Be sure to discuss the benefits and harms of ECT treatment with your doctor.
About OCD. International OCD Foundation website. Available at: https://iocdf.org/about-ocd. Accessed June 15, 2016.
Obsessive compulsive disorder (OCD). EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated June 13, 2016. Accessed June 15, 2016.
Obsessive-compulsive disorder (OCD). National Institute of Mental Health website. Available at: http://www.nimh.nih.gov/health/topics/obsessive-compulsive-disorder-ocd/index.shtml. Updated January 2016. Accessed June 15, 2016.
4/16/2009 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Simpson HB, Foa EB, Liebowitz MR, Liebowitz MR, et al. A randomized, controlled trial of cognitive-behavioral therapy for augmenting pharmacotherapy in obsessive-compulsive disorder. Am J Psychiatry. 2008;165(5):621-630.
7/15/2016 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Fontenelle LF, Coutinho ES, Lins-Martins NM, Fitzgerald PB, Fujiwara H, Yücel M. Electroconvulsive therapy for obsessive-compulsive disorder: a systematic review. J Clin Psychiatry. 2015;76(7):949-957.
- Reviewer: Michael Woods, MD
- Review Date: 06/2016
- Update Date: 07/15/2016