
Contents
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History of Exposure-Based Treatments for OCD History of Exposure-Based Treatments for OCD
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Early Laboratory Research Early Laboratory Research
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An Animal Model of Exposure-Based Therapy An Animal Model of Exposure-Based Therapy
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Translational Research: From the Lab to the Clinic Translational Research: From the Lab to the Clinic
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Contemporary Exposure-Based Treatment Contemporary Exposure-Based Treatment
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Implementation of E/RP Implementation of E/RP
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In Vivo (Situational) Exposure In Vivo (Situational) Exposure
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Imaginal Exposure Imaginal Exposure
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Response Prevention Response Prevention
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Mechanisms Underlying the Effects of Exposure-Based Therapy Mechanisms Underlying the Effects of Exposure-Based Therapy
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Emotional-Processing Theory Emotional-Processing Theory
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Inhibitory Learning Theory Inhibitory Learning Theory
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Violating Negative Expectancies Violating Negative Expectancies
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Decontextualizing Inhibitory Associations Decontextualizing Inhibitory Associations
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Summary and Synthesis Summary and Synthesis
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Efficacy and Effectiveness of E/RP Efficacy and Effectiveness of E/RP
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Dismantling Studies Dismantling Studies
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Differential Effects of Exposure and Response Prevention Differential Effects of Exposure and Response Prevention
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Imaginal and Situational Exposure Imaginal and Situational Exposure
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Summary of Dismantling Studies Summary of Dismantling Studies
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Short- and Long-Term Effects of E/RP Short- and Long-Term Effects of E/RP
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Meta-Analytic Findings Meta-Analytic Findings
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Randomized Controlled Trials Randomized Controlled Trials
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E/RP for Mental Rituals E/RP for Mental Rituals
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Group E/RP Group E/RP
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Home-Based versus Office-Based Treatment Home-Based versus Office-Based Treatment
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Relapse Prevention Relapse Prevention
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Internet, Telehealth, and Smartphone Application Delivery of E/RP Internet, Telehealth, and Smartphone Application Delivery of E/RP
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Relevant Research Evidence and Clinical Application Relevant Research Evidence and Clinical Application
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Involving Family Members in E/RP Involving Family Members in E/RP
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Couple-Based E/RP Couple-Based E/RP
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Family-Based E/RP for Youth Family-Based E/RP for Youth
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Predictors of Response to Exposure-Based Treatment Predictors of Response to Exposure-Based Treatment
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E/RP Procedural Variations E/RP Procedural Variations
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Patient Characteristics Patient Characteristics
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Supportive Factors Supportive Factors
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Conclusions Conclusions
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References References
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19 Exposure-Based Treatment for Obsessive-Compulsive Disorder
Get accessJonathan S. Abramowitz, Ph.D., University of North Carolina at Chapel Hill
Steven Taylor, Ph.D., University of British Columbia
Dean McKay, Ph.D., Fordham University
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Published:16 August 2023
Cite
Abstract
Exposure and response prevention (E/RP) is one of the oldest and most effective treatments for obsessive-compulsive disorder. The present chapter describes the empirical foundations, development, delivery, and latest research on E/RP. Commonly used methods and procedural variants of E/RP are described, along with the underlying mechanisms of action. The efficacy of E/RP in relation to other treatments is discussed, in addition to research on the long-term effects of E/RP and its effects in non-research settings. Pretreatment predictors of the outcome of using E/RP are also considered. Efforts to improve treatment outcome are discussed, such as research into the benefits of including a spouse or partner in E/RP. The chapter concludes by considering important future research directions for improving the outcome of treatment packages that include E/RP.
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