Cognitive Therapy for OCD – Beyond ERP

Delivering cognitive–behavioural therapy (CBT) for obsessive–compulsive disorder (OCD) requires a detailed understanding of the phenomenology and the mechanism by which specific cognitive processes and behaviours maintain the symptoms of the disorder. A cognitive–behavioural model of OCD begins with the observation that intrusive thoughts, doubts or images are almost universal in the general population and their content is indistinguishable from that of clinical obsessions(1). The difference between a normal intrusive thought and an obsessional thought lies both in the meaning that individuals with OCD attach to the occurrence or content of the intrusions and in their response to the thought or image.