Your Child Can Get Better With Effective Treatment
Information for Parents

What Is Cognitive Behavior Therapy (CBT)?

Cognitive Behavior Therapy is a treatment for OCD that uses two evidence-based behavior-altering techniques—Exposure and Response Prevention therapy (ERP) and Cognitive Therapy.  This treatment is conducted by a cognitive behavior therapist who has special training in treating OCD.

In ERP therapy, the person who has OCD is placed in situations where he or she is exposed to the obsessions that they have, and they are gradually prevented from performing the compulsions they use to temporarily ease their fears.

For example, if you have an obsessive fear of germs in public places, your therapist may encourage you to touch a doorknob that you believe is dirty, then wait longer and longer to wash your hands.  This gradual exposure and delayed response would help you learn to control the response.

While at first you would feel very upset—maybe even feel panic because of touching the doorknob—over time, you would learn to respond differently to the fear or thoughts about germs.  This new way of confronting your fear head-on would actually lead to fewer and less intense fears or obsessions about germs.

When your therapist helps you with ”exposures” like this (or other, more difficult kinds of situations involving your fears) over a period of time, your anxiety shrinks until it is barely noticeable or even fades entirely. Effective ERP leads to something called “habituation”, the process of losing the automatic fear response to obsessions, which means your brain learns the very important realization that nothing bad happens when you stop performing compulsive rituals.

The therapist is then able to help you gain confidence and learn special skills to control the compulsions through the second form of therapy, Cognitive Therapy.

Cognitive Therapy (as applied to treating OCD) helps you understand that the brain is sending “error” messages.  Your therapist will help you learn to recognize these errors and respond to them in new ways—to control the obsessions and their resulting compulsive actions. Cognitive Therapy is an effective treatment for many problems, and focuses on the meaning we attach to often-ambiguous experiences (e.g., “Mary doesn’t like me anymore because she walked by without saying hello.”). Cognitive therapy helps people stand back from often-automatic thoughts, look at the evidence closely, and tell themselves something more accurate (e.g., “Something is on Mary’s mind, but I don’t know what it is.”).

Cognitive Therapy for OCD focuses on the experience of negative thoughts. While most people easily dismiss such thoughts (e.g., “that’s a silly thing to think”), certain beliefs (e.g., thoughts seen as always important) cause some to react differently (e.g., “I am a bad person for having such a thought!”). Research shows that understanding negative thoughts as important and attempting not to have “bad” thoughts produces the opposite effect!

Cognitive therapy for OCD sometimes focuses on metacognition (what we think about thinking processes). The therapist helps the person challenge specific metacognitive beliefs. For example, if you think, “I am as rich as Warren Buffett,” do you need to go and check your bank account?

This treatment may seem unusual.  You may even be skeptical about it.  After all, you’ve probably already tried to resist compulsions without much success. But with the right therapist, and given time and support, Cognitive Behavior Therapy has helped many thousands of people (children, teens and adults) control their OCD.

Most ERP treatment is conducted at a therapist’s office (or other location) once a week with exercises to practice at home between sessions.  If the OCD is very severe, more frequent sessions might be needed.

Not all mental health professionals are trained in ERP therapy, so it’s important to find one who is.  OCD Chicago can help you and your parents find a treatment provider.

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