Psychopathology:Psychopathology:

Psychological therapies for Psychological therapies for OCDOCD

Behavioural therapy – Behavioural therapy – 1) Exposure and Response Prevention 1) Exposure and Response Prevention

(ERP) therapy(ERP) therapy ERP is about ERP is about

reconditioning.reconditioning.

It consists of two It consists of two components:components:

Exposure – forcing the Exposure – forcing the patient to patient to experience the experience the stimulus stimulus and learn, through and learn, through association with relaxation, association with relaxation, that it no longer produces that it no longer produces anxiety.anxiety.

Response prevention – at Response prevention – at the same time the patient is the same time the patient is also prevented from also prevented from engaging in their usual engaging in their usual compulsive rituals. The compulsive rituals. The patient must learn that patient must learn that anxiety can be reduced anxiety can be reduced without without the compulsive the compulsive ritual.ritual.

Both obsessions and Both obsessions and compulsions have been compulsions have been acquired through acquired through conditioning.conditioning.

In order to recover, patients In order to recover, patients must ‘unlearn’ this behaviour.must ‘unlearn’ this behaviour.

Obsessions are maintained Obsessions are maintained through negative through negative reinforcement.reinforcement.

Compulsive rituals have Compulsive rituals have become associated with become associated with anxiety reduction.anxiety reduction.

Behavioural therapy – Exposure and Behavioural therapy – Exposure and Response Prevention (ERP) therapyResponse Prevention (ERP) therapy

Mode of action:Mode of action:

Psychiatrist Psychiatrist identifies list of identifies list of target symptoms target symptoms using Y-BOCSusing Y-BOCS

List of items ranked List of items ranked by patient from least by patient from least to most anxiety to most anxiety provoking.provoking.

13-20 weekly 13-20 weekly sessions (average)sessions (average)

Sometimes monthly Sometimes monthly booster sessions set booster sessions set up to prevent up to prevent relapse.relapse.

ERP for OCDERP for OCD

http://www.channel4.com/programmes/help-me-help-my-child/4od#3107618

2) Cognitive-behavioural therapy2) Cognitive-behavioural therapy

Cognitive therapies focus Cognitive therapies focus on changing thoughts, in on changing thoughts, in contrast to behavioural contrast to behavioural therapies which focus on therapies which focus on changing behaviour.changing behaviour.

Aims to identify, challenge Aims to identify, challenge and modify dysfunctional and modify dysfunctional beliefs and the behaviours beliefs and the behaviours that these will result in.that these will result in.

Cognitive therapists believe Cognitive therapists believe that the behaviourists that the behaviourists overlook and ignore the overlook and ignore the influences of a person’s influences of a person’s thinking on psychological thinking on psychological disorders.disorders.

Our behaviour is the Our behaviour is the product of our thoughts, product of our thoughts, therefore we should first of therefore we should first of all address the thoughts.all address the thoughts.

E.g. ‘I must switch this light E.g. ‘I must switch this light on and off 23 times or on and off 23 times or something terrible will something terrible will happen to me or my family.’happen to me or my family.’

This irrational thought will This irrational thought will be challenged and a patient be challenged and a patient will be required to practise will be required to practise certain optimistic certain optimistic statements which challenge statements which challenge their cognitions.their cognitions.

Cognitive-behavioural therapyCognitive-behavioural therapy

Typical dysfunctional beliefsTypical dysfunctional beliefs

1) Unrealistic responsibility 1) Unrealistic responsibility appraisals – appraisals – see themselves as see themselves as solely responsible for prevention of solely responsible for prevention of negative outcomes to themselves negative outcomes to themselves or those they love.or those they love.

Over-importance of thoughts Over-importance of thoughts – – sufferer may feel that having a sufferer may feel that having a thought (e.g. someone dying) will thought (e.g. someone dying) will mean it will happen.mean it will happen.

Exaggerated perception of Exaggerated perception of threat – threat – irrational belief in irrational belief in harmful outcomes.harmful outcomes.

You will now be given You will now be given an activity which will an activity which will enable you to:enable you to:

1) understand more 1) understand more about these two about these two therapiestherapies

2) 2) evaluate themevaluate them..