Obsessive Compulsive Disorder

Abstract:

The development of basic competence and the progression from basic to expert competence in delivering cognitive behavioral therapy (CBT) for obsessive compulsive disorder (OCD) is a complex endeavor that has rarely been the focus of discussion in the literature despite the obvious importance of the topic. In this chapter we endeavored to develop a basic set of therapist skills that range from: 1) comprehensive and yet focused assessment of core symptoms; 2) differential diagnosis from disorders that overlap OCD; 3) clinical management of the common comoridities likely to be encountered; 4) providing a clear rationale for the treatment procedures that flow logically from a neurobehavioral framework; 5) conveying the current state of the treatment literature and its implications for treatment choice; and 6) developing reliance on the conceptual model of OCD to inform treatment progression. The movement from basic competence to expert delivery of CBT for OCD requires continuing education and monitoring of the extant literature, treating a sufficiently high volume of cases to master the heterogeneity of OCD presentation, and therapists’ willingness to acknowledge what they do not yet know and persistence in seeking out professional opportunities to bridge the gaps in their knowledge.