About CBT

Cognitive Behavioral Therapy (CBT) is an approach to understanding and treating psychological disorders.

This treatment involves you learning skills to help change your thinking and behavior patterns.

It is an evidence-based treatment designed to get results.

CBT is a behavioral treatment as opposed to psychoanalytic or psychodynamic therapies, which are more insight oriented, and less action oriented. Cognitive behavioral therapy includes a number of techniques and interventions.

Thus the label CBT can mean many things. For example, therapists use a form of Cognitive Behavioral Therapy called Dialectical Behavior Therapy (DBT) for the issue of cutting/self injury/suicidal ideation. Dialectical Behavior Therapy is a form of Cognitive Behavioral Therapy. However, it is not the primary treatment of OCD, for example. So when looking for Cognitive Behavioral Therapy, what type of Cognitive Behavioral Therapy you should seek is based on the diagnosis being treated.  In other words the choice of which CBT techniques to use depends on what your diagnosis is.

Exposure and response prevention (ERP) is a form of Cognitive Behavioral Therapy (CBT) that is well studied and known to be particularly effective for treating OCD and other anxiety disorders. In Exposure and response prevention, the therapist plays a more directive role in helping you change the thoughts and behaviors that are keeping you stuck.

As a client is important that your provider be doing ERP specifically and not just CBT generally.  This is important because Exposure Therapy is the “best practice” and standard of care for treating OCD.  Too often OCD clients report that they have been to a provider who claims to treat OCD and do CBT but the client never actually receives Exposure and Response Prevention therapy.  Sometimes clinicians are using outdated CBT techniques like thought stopping, which is not indicated for the treatment of OCD.

If a client believes they have tried CBT for OCD but were never really given the proper treatment (exposure therapy) then they get no symptom relief, and lose faith in the idea that CBT can help them. CBT can help you if it includes Exposure and Response Prevention therapy.   Exposure therapy is effective and it can help you!

With that said, depending on your diagnosis exposure therapy may or may not be indicated. There are other CBT techniques we use for other disorders. If you suffer from trichotillomania for example, the emphasis would be on the CBT techniques of Habit Reversal Training and the ComB model, rather than exposure.  So getting a proper assessment by an experienced therapist is necessary and beneficial.

 

Recommendations for consumers

There are many clinicians offering their services, and many of these clinicians state they treat OCD and anxiety disorders.  It is best to work with someone who has experience and has been working with these types of disorders for at least 5 years.  To make sure you are getting someone who is experience and knowledgeable ask your provider the following questions.

Ask:  How long have you been treating OCD/OC spectrum and other anxiety/depressive disorders?

Ask: Do you do ERP for OCD?

Ask: What is your training in CBT and exposure therapy?

Ask: How many cases of depression, OCD, or panic, social anxiety, generalized anxiety, separation anxiety, health anxiety, BDD, trich, have you treated?