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Discuss psychological therapies for obsessive compulsive disorder

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Discuss psychological therapies for obsessive compulsive disorder (8+16 marks) One behavioral therapy is Exposure and response prevention (ERP) therapy. The behavioral approach assumes that obsessions and compulsions are learned through conditioning and therefore for patients to recover they must unlearn these behaviors. ERP provides opportunities for re-conditioning the compulsions and obsessions the patient has learnt. Firstly the psychiatrist constructs a list of compulsions and obsessions using Y-BOCS and then is ranked by the patient from least to most anxiety provoking circumstances. The psychiatrist moves up the rank, enabling the patient to experience the feared stimulus and then learns to associate the stimulus with relaxation, until the anxiety subsides (habituation). The second step is response prevention, where the patient is prohibited from engaging in a compulsive behaviour. This enables the patients to see that anxiety subsides even when the compulsive ritual is not performed, allowing the person to unlearn the compulsive acts. ...read more.


Research from Foa et al (2005) demonstrated that a combination of the tricyclic clomipramine and ERP (exposure and response prevention) was more effective in treating symptoms of OCD than using either alone. This suggests that psychological treatments over-simplify OCD in terms of assuming that OCD is a result of learning and maintaining obsessions and compulsion through reinforcement but research has acknowledged that there may also be other elements affecting OCD and therefore requires a combination of therapies to prove effective in treating OCD. Another psychological therapy is cognitive therapy (CT). This involves the psychiatrist questioning the patient on how they interpret their obsessions (their attitude to the obsession and the reason they believe they have the obsession). This anxiety evoking obsession is then challenged and misinterpreted so that that obsession is not perceived as a high risk activity. ...read more.


An issue surrounding the treatment of CT is that it may not be appropriate for all patients. For instance, CT requires considerable effort and motivation from the patient to prove effective. The therapy on average takes around 14-20 weekly sessions (may be more or less depending on the extremity of the obsessions and compulsions) which requires commitment and persistence in order to see results. For example the patient has to practice maintaining their new ?interpretations? on anxiety evoking situations in order to prove effectiveness. This may be perceived as a huge effort for a patient who may view drug therapies (chemotherapy) as easy consequently motivating them to discontinue with the course (due to its lengthy nature whose results are witnessed only in the long term) thus proving the inefficiency of CT. ...read more.

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