Interoceptive Exposure in OCD Treatment
Interoceptive exposure (IE) involves using exercises (e.g., hyperventilation) to deliberately evoke feared bodily sensations (e.g., shortness of breath; tightness in chest). It is most commonly associated with panic disorder treatment. In a recent paper, anxiety disorders [...]
SUDS vs. Willingness: Values-Based ACT Exposure for OCD
Throughout the years, I’ve written a series of blogs posts on exposure therapy, including the use of exposure therapy in Acceptance and Commitment Therapy. In the absence of much guidance on using exposure in ACT, I co-authored [...]
Study Suggests Clients Don’t Dropout of ERP for OCD More Than for Any Other Treatment
A common figure for the dropout rate of exposure and response prevention (ERP) for people with obsessive-compulsive disorder is about 25%. During one OCD workshop I attended, 2 different presenters insinuated that these high rates of dropout [...]
An Article about Guiding Exposure Work for OCD
Exposure and Response prevention (ERP) is the most effective treatment for OCD. However, it remains under-utilized by therapists even though it is preferred by people with OCD who are educated about treatment options. Therapist avoidance [...]
What One Sports Fan with OCD Learned from LeBron James
Much of what drives people with obsessive-compulsive disorder (OCD) is a fear of uncertainty. People with OCD may engage in frequent and/or time consuming rituals in order to ward off a feared outcome, no matter [...]
Hair Pulling (AKA Trichotillomania) and Skin Picking Problems
Greater Research Support for Behavior Therapy over Medication Trichotillomania (or trich for short) is a condition in which people repeatedly pull out their body hair, often leading to bald patches and thinning. The scalp is [...]
Psychotherapy vs. Medication for OCD – Which is More Effective?
Obsessive-Compulsive Disorder (OCD) is a serious and disabling problem for many people. Understandably, many people seek out medication to help with this problem, and research is shown that medication can be helpful some people. However, [...]
The Difficulties of Accessing Effective Treatment: OCD as an Example
I resonated with a recent article in Psychology Today about the difficulties people have in finding therapists who offer effective treatment. The authors Dean McKay and Scott Lilienfeld—especially Dr. Lilienfeld—have been extremely active in promoting [...]
Book Review: OCD, A Guide for the Newly Diagnosed
Although OCD is commonly used to describe someone who is overly tidy, this stereotype doesn’t capture the common struggles of someone with obsessive-compulsive disorder. Perhaps as a consequence of stereotypes such as this, many people [...]
Treating Skin Picking with Acceptance-Enhanced Behavior Therapy
Excoriation or skin picking has often been in the shadow of its nearest relative, trichotillomania or repetitive hair pulling. One good thing to come out of the DSM-5 was that it finally made skin picking disorder an official diagnosis—excoriation. [...]
An Alternative to Exposure and Response Prevention for OCD
Numerous studies have now shown that Exposure and Response (or Ritual) Prevention (ERP) remains our most effective treatment for obsessive-compulsive disorder (OCD). In ERP, clients deliberately confront feared stimuli while learning to refrain from engaging in [...]
More Avoidant Therapists Are Less Likely to use Exposure in OCD Treatment
In a previous post, I linked to a blog post about therapist reluctance to use exposure therapy. Exposure therapy is one of the most effective interventions for anxiety-related problems but, sadly, remains under-utilized by clinicians. It is an [...]
A Great Blog Post About Therapist Reluctance to Use Exposure
Eric Morris, PhD, a psychologist in Australia, wrote a really interesting blog post about therapist reluctance to use exposure. As I’ve written about in previous posts, exposure therapy is one of the most effective interventions we have [...]
Why Understanding Theory is Important in Conducting Exposure Therapy
In a special issue of Behavior Therapy on “The Theory-Practice Gap in Cognitive Behavior Therapy,” Jonathan Abramowitz, PhD, authored an interesting paper on the importance of understanding theory when doing exposure therapy. Dr. Abramowitz is a well-respected OCD researcher, and [...]
Cognitive Behavioral Therapy Superior to Antipsychotics for OCD
A practice I’m seeing more often that concerns me is the addition of antipsychotic medications on top of antidepressants when the antidepressants aren’t working. If someone isn’t showing improvement on an antidepressant alone, a prescriber [...]
A Meta-Analysis Comparing Psychotherapy and Medication for OCD
This post was featured on our client-centered blog The Art and Science of Living Well, but I thought it would be of interest to therapists as well. The post is about a finding from a meta-analysis by [...]
Using TLC to Learn About Hair Trichotillomania
A few years ago, my clinic director suggested I check out trainings offered through the Trichotillomania Learning Center (TLC), a grassroots hub for information on trichotillomania and skin pulling (or dermatillomania). He knew about my interest in structured treatments [...]
How Do You Use Exposure in Acceptance and Commitment Therapy?
In June, Utah State professor Mike Twohig is coming to Portland to conduct a daylong workshop on using exposure in Acceptance and Commitment Therapy (ACT). [As a side note, I did my first ACT training with [...]