Telehealth and in-person therapy throughout the state of Connecticut
Cognitive Behavioral Therapy with Exposure and Response Prevention
What is OCD?
Obsessive Compulsive Disorder causes an intense loop of obsessions (unwanted/ intrusive thinking) and obsessions (engagement in compulsive/safety behaviors in order to decrease related obsessions). The common result is significant distress which negatively impact individual’s engagement in major areas of life including family and friend relationships, socializing, school, healthcare and employment. Fearless Futures Therapy can help you with managing Obsessive Compulsive Disorder and working towards a fearless future! Individual therapy services are provided utilizing a variety of therapeutic approaches including Cognitive Behavioral Therapy with Exposure and Response Prevention, Inference-Based Cognitive Behavioral Therapy and Acceptance and Commitment Therapy.
There are many subtypes of Obsessive Compulsive Disorder including fears related to:
- Contamination
- Self-harm
- Harming others
- Hoarding
- False memories
- Sexual obsessions
- "Just right”
- Existential fears
- Symmetry
- Inappropriate thoughts
- Relationships (romantic, family, etc)
- Somatization
- Physical health
- Real events
- Taboo subjects
What is Cognitive Behavioral Therapy?
Cognitive Behavioral Therapy involves looking at the pattern of events (triggers/stressors) that impact our feelings, thoughts and behaviors and how they relate to each other. Cognitive Behavioral Therapy with Exposure and Response Prevention takes it a step further to look at the experienced obsessions and compulsions and their relationship to each other. In the image shown below, you can see that the obsessions lead to increase distress and then individuals engage in safety behaviors or compulsions in an attempt to decrease the related distress. Individuals frequently then experience brief relief from the obsession, however, these obsessions become stronger over time particularly when individuals engage in the compulsive behaviors. We work with individuals to identify trigger/stressors that lead to the obsessive thought patterns and compulsive behaviors and build an individualized exposure or “fear” hierarchy. This hierarchy serves as the roadmap for your individualized treatment and engagement in the behavioral assignments within the hierarchy will support you in decreasing the symptoms of Obsessive Compulsive Disorder. Ultimately, the symptoms of Obsessive Compulsive Disorder are thoroughly attacked which helps individuals to continue to live their life by their rules and to their values rather than be constricted by this never-ending loop of obsessions and compulsions.
So what does Cognitive Behavioral Therapy with Exposure and Response Prevention look like?
Cognitive Behavioral Therapy with Exposure and Response Prevention is:
- Individualized (based on personally experienced obsessions and compulsions)
- Values driven
- Specifically targeted to improve functioning across all setting (social, employment, school, etc) and work towards your dreams of tomorrow
Initial steps of Cognitive Behavioral Therapy with Exposure and Response Prevention
Step 1.
Assessment
Step 2.
Trigger/Stressor Identification
Step 3.
Build Exposure or “Fear” Hierarchy
Step 4.
Pick initial exposures.
A Typical Cognitive Behavioral Therapy with Exposure and Response Prevention Session
Start of session:
Brief check-in, updates
Discuss exposures for session:
Decide what exposures we will do today.
Review of completed exposures:
On- going discussion and processing of exposures
Culmination/Wrap Up:
Discussion regarding session, next steps
Within these subtypes of Obsessive Compulsive Disorder, individuals experience obsessions or intrusive/unwanted thoughts including distressing thoughts, urges, mental images and “what if” thoughts and doubts. Common obsessions within the different subtypes can look like:
- Contamination: fear of touching door knobs due to fear of becoming sick or causing loved ones to get sick
- Harming self: what if I cut myself while I am shaving today or what if I cut myself with a knife while I’m doing the dishes
- Relationships: what if I’m not faithful to my partner or what if I am actually not being myself with my family
Cognitive Behavioral Therapy with Exposure and Response Prevention works well with Acceptance and Commitment Therapy. Please see the Acceptance and Commitment Therapy specialty page for additional information.
Behavioral activation can be a great addition to your therapy regimen when experiencing depressive symptoms, please see the (link) Behavioral Activation specialty page for additional information.