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12 - CBT for OCD:

Evidence-Based Treatment for Contamination and Checking

from Part Three - Cognitive Behavioral Therapy for Obsessive-Compulsive Disorder and Associated Disorders

Published online by Cambridge University Press:  06 January 2022

By
Elizabeth A. Forrester
Edited by
Gillian Todd  and
Rhena Branch
Gillian Todd
Affiliation:
University of East Anglia
Rhena Branch
Affiliation:
University of East Anglia
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Summary

Contamination concerns and checking remain two of the most prevalent forms of presentation in OCD, reported by 25–50% of sufferers, with checking the most common compulsion. Since they cover a broad spectrum of concerns and complexity, the assessment and treatment of contamination and checking carries its own challenges for the therapist. This chapter explores the nature of contamination and checking concerns and provides an overview of recent research. Practical advice and guidance will guide the therapist from initial assessment to formulation and the development of an effective treatment protocol. The prevalence of covert safety-seeking behaviors such as rumination is discussed as a frequent obstacle in treatment. It advocates a move away from graded hierarchies for exposure and considers what effective exposure should consist of, encouraging the use of creativity and playfulness. A range of both common and less common presentations is used to illustrate key concepts.

Keywords

obsessive-compulsive disordercontaminationcheckingovert and covert compulsionsTheory A/Theory Boverestimation of threatruminationexposuregraded hierarchythird wave CBT
Type
Chapter
Information
Evidence-Based Treatment for Anxiety Disorders and Depression
A Cognitive Behavioral Therapy Compendium
 , pp. 222 - 251
Publisher: Cambridge University Press
Print publication year: 2022

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References

Further Reading for Therapists

Bream, V., Challacombe, F., Palmer, A., & Salkovskis, P. (2017). Cognitive behaviour therapy for OCD. Oxford University Press.Google Scholar
van Niekerk, J. (2018). A clinician’s guide to OCD. New Harbinger Publications.Google Scholar

Further Reading for Patients

Challacombe, F., Salkovskis, P. M., & Oldfield, V. B. (2011). Break free from OCD: Overcoming obsessive compulsive disorder with CBT. Vermilion.Google Scholar
Forrester, E (2015). How to deal with OCD. John Murray Learning, Hodder & Stoughton.Google Scholar

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