Cognitive Behavioral Therapy (CBT)
Cognitive Behavioral Therapy (CBT) is a psychological treatment or type of psychotherapy that treats a wide range of mental health issues and disorders. CBT is an umbrella term that covers many types of specific therapies such as Exposure and Response Prevention (ERP) for OCD and other anxiety disorders as well as Mindfulness Training and Acceptance and Commitment Therapy (ACT).
Cognitive Behavioral Therapy is the most researched form of psychotherapy and based on thousands of research studies CBT has been found to be effective for many different mental health disorders. CBT is considered the gold standard treatment for OCD and Anxiety related disorders.
CBT is a time sensitive, structured therapy that is tailored to the needs of each individual client. CBT focuses on how thoughts, feelings and behaviors interact with each other. CBT therapists focus on helping clients with current problems and teaching them skills to change their thinking and behavior. An important goal of CBT treatment is to help clients learn to be their own therapist by practicing techniques they can use for the rest of their lives.
As conscious beings, we continually interpret the world around us – and sometimes our brains make mistakes in that interpretation. These mistakes are known as Cognitive Distortions or “thinking errors.”
One example of a common cognitive distortion found in all anxiety disorders is Catastrophic Thinking, “when a person makes a sweeping negative conclusion without considering more likely possibilities.” An example is when someone who gets a headache assumes they have a serious illness, or when a student who takes an exam they were well prepared for assumes they failed it. These interpretations can cause a person to feel anxious when in reality they have not considered other possibilities, such as a more likely reason for the headache, or that preparing for the exam will likely means a good result.
Cognitive Restructuring is an evidence-based CBT technique that is an adjunctive treatment for OCD and related disorders. It refers to the act of identifying ineffective patterns in thinking, and then changing them to be more effective and skillful. Cognitive restructuring is not making thoughts more positive. Instead, it is learning the skill of becoming aware of unhelpful patterns of thought, and learning to broaden our perspectives on the thought and restructure it so it is rational, reasonable and balanced.
Exposure and Response Prevention (ERP)
ERP is a cognitive behavioral therapy technique that is highly effective for the treatment of OCD and related disorders. ERP involves a gradual exposure to anxiety-provoking thoughts, feelings, and situations while choosing not to do an automatic response or compulsion. The goal of ERP is to gradually practice a new, effective way of responding to the disorder while refraining from doing compulsions. Through this process, clients learn to tolerate anxiety and discomfort while their mind gradually learns these fears are not so important and dangerous. Over time and with repeated exposures the anxiety lessens on its own.
Exposure and Response Prevention is a collaborative and compassionate process. The first step of ERP is identifying the mental and physical compulsions clients are currently doing to reduce anxiety from OCD and related disorders triggers. Together, the therapist and client create a hierarchy of the compulsions to eliminate, from easiest to hardest. In treatment, clients learn tools to help them with this process. They continue to work on gradually facing the fears and responding to the disorder’s thoughts, feelings, and sensations in a new way that does not feed the disorder. Clients are in charge of the exposures that they choose to do, and the pace they do them.
Anxiety, OCD, and all obsessive-compulsive spectrum disorders bring unwanted thoughts and feelings. Often our first reaction is to try to control these difficult internal experiences, which is understandable but not effective. Mindfulness teaches clients a different and skillful way to respond to unwanted thoughts, feelings, and sensations. And studies show that incorporating Mindfulness improves recovery outcomes for Anxiety, OCD and related disorders.
Mindfulness is the practice of observing our thoughts, feelings, sensations, and urges, without judgment in the present moment. Mindfulness training teaches clients how to allow these unwanted internal events to be there, without engaging with them. With practice, clients learn that their distressing thoughts, feelings, and sensations eventually go away on their own without ever doing the compulsion.
Acceptance and Commitment Therapy (ACT)
ACT is a psychological treatment approach under the umbrella of CBT and is another science-backed therapy. The aim of ACT is to help clients build rich and meaningful lives, while effectively handling the pain and discomfort that inevitably comes with it.
This therapy approach helps clients clarify their values and use them as a compass to guide their life rather than let their difficult thoughts and feelings determine their actions. To accomplish this ACT emphasizes mindfulness tools to help clients open up and make room for their unwanted thoughts, feelings, sensations, and urges, and without trying to control them or push them away.
The ACT approach enables clients to focus their attention on what’s important in the present moment, fully engaged in what they are doing. Simply put, the aim of ACT is to help clients open up, be present and do what matters.