ABSTRACT
The specialized treatment approach for Obsessive-Compulsive Disorder (OCD) described in this chapter is delivered at the specialized clinic for OCD and Related Disorders at the McGill University Health Centre in Montreal that since 1987 accepts OCD patients of all ages regardless of comorbidity or illness severity. The following concepts were proposed as relevant to OCD symptoms: schemas; developmental theory; role of attachment experiences; constructivist model of identity structure; and metacognitive and appraisal theory. Leahy and colleagues have focused on the important concept of emotional schemas, elaborating in theory and practice individuals' experience and regulation of emotion as central to the development and maintenance of psychopathology. In understanding the theoretical construct of schemas and the proposed "tacit" level of information processing and awareness, it is important keep in mind that Cognitive behavioural therapy (CBT) was originally developed in part to address the limitations in theory, practice, and outcome of earlier existing approaches, most notably the psychoanalytic approach.
