ABSTRACT
Cognitive behavioral therapy (CBT) involving exposure and response (ritual) prevention (EX/RP) is an empirically based treatment of established efficacy for obsessivecompulsive disorder (OCD). (For a review see Franklin & Foa, 2002.) Exposure to feared thoughts and situations is a fundamental component of this treatment, as is the voluntary abstinence from rituals and other forms of passive avoidance (e.g., wearing gloves in order to touch doorknobs). Although avoidant strategies can seem helpful in the short run because they alleviate anxiety temporarily, such avoidance has long-term consequences of maintaining anxiety by preventing the client from learning that the feared consequences of confronting situations are unlikely to occur and that anxiety would habituate over time even without rituals. Thus, in treating clients with OCD, it is essential to use exposure to feared thoughts and stimuli and to encourage cessation of all rituals and overt avoidance in order to maximize the effect of CBT involving EX/RP. Further, because treatment sessions typically last only 2 hours each day (Kozak & Foa, 1997), it is imperative to assign exposure and response prevention exercises for clients to complete between treatment sessions; this approach is even more crucial when treatment sessions are shorter and conducted less frequently (e.g., 60-minute sessions held once a week).
