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  • Q&A with Australian Health Practitioners

    Is behavioural therapy effective for treating OCD?

    I've been put on medication to control my OCD however i have been looking into behavioural therapy as i dont like taking medication. Could behavioural therapy work instead of my medication or in addition to it? Would it be effective?
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    Offers information and education advice about protecting mental health, mutual support and advocacy services. View Profile

    There are a number of behavioural therapies that assist in the prevention and reduction of available and it is important to realise that each individual set of symptoms will vary. Therefore interventions need to be individually tailored to ensure the best possible outcomes are achieved because certain therapies will be more efficacious for some people and not others.

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    My research interests include immunology and the mechanisms of amyloid formation. The latter has implications for people who are dealing with Alzheimer's Disease, Parkinson's Disease … View Profile

    Two behavioural therapeutic approaches which can help people with OCD are Cognitive Behavioural Therapy (CBT) and Exposure and Response Prevention (ERP). 

  • I am a Clinical Psychologist. I believe in providing care which is responsive to the individual needs of my clients to promote their psychological wellbeing. View Profile

    Relaxation-based approaches could be effectively coupled with Exposure and Response Prevention to enhance treatment effects. These approaches are specific components of Cognitive Behaviour Therapy with an evidence base for the treatment of OCD.

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    Penny Lewis

    Clinical Psychologist, Counsellor, Psychologist, Psychotherapist

    I am a Clinical Psychologist with more than 25 years experience working with adults with a broad range of backgrounds dealing with a wide variety … View Profile

    I recently reviewed the research on this and found that while medication is effective in the treatment of OCD, only 40-60% of clients respond to it and it produces only a modest improvement (20-40%) in symptoms. Yet around 75% of those treated with CBT improve significantly typically with a 50-70% reduction in symptoms. Further, as you know, medications often have unwanted side-effects and may require indefinite continuation to prevent relapse. I was interested to find that adding medication to CBT did not improve the outcome of therapy unless the client was severely depressed or had poor insight into their condition. If clients are not responding to the medication, adding in CBT has been found to enhance the effects of medication. So I would recommend you seek out some CBT (which may involve the behavioural technique of exposure and response prevention, but can also involve strategies to help you change unhelpful beliefs). See also my other answers on best treatments for OCD.

  • The Australian Psychological Society publishes a scientific review of evidence-based psychological interventions for mental disorders every few years. In the latest edition, on the evidence for OCD interventions, it states:

    There is Level I evidence for cognitive behaviour therapy (CBT) and Level II evidence for self-help (primarily CBT-based) in the treatment of obsessive compulsive disorder (OCD) in adults. One study with a small sample size provided Level IV evidence for acceptance and commitment therapy (ACT). In the current review, there was insufficient evidence to indicate that any of the remaining interventions were effective.

    N.B.: Level I is the highest level of evidence.

    So it's pretty clear that the evidence strongly supports CBT as an effective treatment for OCD, and ACT (another behavioural therapy) is also likely to be effective.

    This is not to say that other approaches are not effective, just that there is currently insufficient evidence (i.e. large, scientific studies) to demonstrate their effectiveness.

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