Journal of Contemporary Psychotherapy

, Volume 47, Issue 1, pp 31–39 | Cite as

When Exposures Go Right: Effective Exposure-Based Treatment for Obsessive–Compulsive Disorder

  • Cary JordanEmail author
  • Adam M. Reid
  • Andrew G. Guzick
  • Jessica Simmons
  • Michael L. Sulkowski
Original Paper


Cognitive behavioral therapy with exposure and response prevention (CBT-E/RP) is the first-line treatment for obsessive–compulsive disorder (OCD). Several CBT-E/RP treatment manuals exist, yet clinicians still struggle to implement this evidence-based form of therapy. This article aims to help clinicians implement exposure-based treatment for OCD by providing practical treatment-enhancing strategies. In particular, literature and treatment recommendations related to effective hierarchy formation, strategic exposure design, and optimal exposure implementation is reviewed. Clinical case examples are provided throughout the paper to illustrate important principles, concepts, and recommendations. This paper aims to enhance the delivery of CBT-E/RP and address common questions and concerns that both new and advanced clinicians encounter when learning and applying this form of psychotherapy. Improving the integrity of CBT-E/RP delivery can improve therapeutic outcomes, patient compliance, and successful treatment completion.


Exposure-based therapy Psychotherapy Evidence-based treatment OCD Clinical recommendations 



This paper did not have any funding.

Compliance with Ethical Standards

Conflict of Interest

Author Cary Jordan, Adam Reid, Jessica Simmons and Michael Sulkowski authors declare they have no conflicts of interest.

Ethical Approval

This article does not contain any studies with human participants or animals performed by any of the authors.


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Copyright information

© Springer Science+Business Media New York 2016

Authors and Affiliations

  • Cary Jordan
    • 1
    • 2
    Email author
  • Adam M. Reid
    • 3
    • 4
  • Andrew G. Guzick
    • 4
  • Jessica Simmons
    • 5
  • Michael L. Sulkowski
    • 6
  1. 1.St. Elizabeth Boardman Hospital, Family Health CenterBoardmanUSA
  2. 2.Family and Community MedicineNortheast Ohio Medical UniversityRootstownUSA
  3. 3.Department of PsychiatryHarvard Medical SchoolBostonUSA
  4. 4.Division of Medical Psychology, Department of PsychiatryUniversity of FloridaGainesvilleUSA
  5. 5.Rogers Behavioral Health-NashvilleNashvilleUSA
  6. 6.Department of Disability and Psychoeducational Studies, College of EducationUniversity of ArizonaTusconUSA

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