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Unread September 14th, 2005, 07:02 AM
joel p joel p is offline
Join Date: Sep 2004
Posts: 8
Default relapse rate for cbt vs. exrp for ocd

have been searching a bit for research comparing behavioral exposure vs. cognitive therapy for OCD especially in regard to the extent of relapse.

in addition, i have been wondering if an axis II disorder such as ocpd would indicate a more depth-oriented therapy (such as Schema therapy or even psychodynamic therapy) in terms of long term freedom from sysmptoms (regardless of other possible gains of such treatment).

any info, thoughts musings or obsessions on this topic would be appreciated.
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Unread September 20th, 2005, 09:45 PM
James Pretzer James Pretzer is offline
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Join Date: Jun 2004
Posts: 283
Default Re: relapse rate for cbt vs. exrp for ocd

I don't remember seeing anything empirical comparing relapse rates for behavioral exposure vs Cognitive Therapy for OCD. However, remember that Cognitive Therapy for OCD would usually include a major amount of time spent on exposure and response prevention.

If you meant to ask about how cognitive interventions without behavioral exposure would compare vs behavioral exposure alone (i.e. no cognitive interventions), we'd expect behavioral exposure to work fine without cognitive interventions if you can get the clients to follow through. We'd expect cognitive interventions to be much more effective when accompanied by behavioral exposure. I wouldn't expect cognitive interventions alone to be very effective and to have a higher relapse rate but I don't remember seeing any data on this.

Just about all of the OCD experts recommend combining cognitive interventions with exposure and response prevention (or variants of this) when treating OCD.

On your second point, I'd recommend CT for OCPD (or whatever Axis II problem there is) in addition to the treatment described above when there is a concurrent Axis II disorder. (Remembering that CT for Axis II problems involves quite a bit more work on interpersonal relationships and schema change that CT for the Axis I problem does.) Clinical Applications of Cognitive Therapy (Second Edition) has a good discussion of CT with OCPD.

There is more empirical support for CT with Axis II problems than there is for most "depth" approaches and I don't know of any evidence that "depth" approaches have benefits that CT doesn't have.
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