Behavior Therapy and Cognitive Behavior Therapy are types of treatment that are based firmly on research findings. These approaches aid people in achieving specific changes or goals.
Changes or goals might involve:
A way of acting: like smoking less or being more outgoing;
A way of feeling: like helping a person to be less scared, less depressed, or less anxious;
A way of thinking: like learning to problem-solve or get rid of self-defeating thoughts;
A way of dealing with physical or medical problems: like lessening back pain or helping a person stick to a doctor’s suggestions.
Behavior Therapists and Cognitive Behavior Therapists usually focus more on the current situation and its solution, rather than the past.
They concentrate on a person’s views and beliefs about their life, not on personality traits.
Behavior Therapists and Cognitive Behavior Therapists treat individuals, parents, children, couples, and families.
Replacing ways of living that do not work well with ways of living that work, and giving people more control over their lives, are common goals of behavior and cognitive behavior therapy.
HOW TO GET HELP:
If you are looking for help, either for yourself or someone else, you may be tempted to call someone who advertises in a local publication or who comes up from a search of the Internet.
You may, or may not, find a competent therapist in this manner.
It is wise to check on the credentials of a psychotherapist.
It is expected that competent therapists hold advanced academic degrees.
They should be listed as members of professional organizations, such as the Association for Behavioral and Cognitive Therapies or the American Psychological Association.
Of course, they should be licensed to practice in your state.
You can find competent specialists who are affiliated with local universities or mental health facilities or who are listed on the websites of professional organizations.
You may, of course, visit our website (www.abct.org) and click on "Find a CBT Therapist"
The Association for Behavioral and Cognitive Therapies (ABCT) is an interdisciplinary organization committed to the advancement of a scientific approach to the understanding and amelioration of problems of the human condition.
These aims are achieved through the investigation and application of behavioral, cognitive, and other evidence-based principles to assessment, prevention, and treatment.
Although once thought to be a relatively rare condition, obsessive-compulsive
disorder (OCD) is now recognized to be a common and often debilitating
form of mental illness. Two to three percent of the population
experience OCD during their life. OCD affects people throughout the
world, regardless of the culture in which they live. In adults more women
than men experience OCD, but in children, it is almost twice as likely to
There are two different times that OCD manifests itself initially, and
they are distinguishable onset patterns. For the early-onset group, OCD
begins on average at about age 11. The late-onset OCD group first experiences
the condition in their early 20s. Early-onset OCD occurs in about
three-quarters of the individuals who suffer from the disorder.
In the current classification system for mental health problems, OCD is
no longer considered an anxiety condition but is grouped with several
other problems considered to have important similarities to OCD. OCD is
understood to involve the frequent experience of obsessions, compulsions,
or both. Most people who experience OCD have both obsessions
and compulsions. Obsessions are unwanted or distressing thoughts, images,
or urges. Compulsions are defined as repetitive behaviors or
thoughts (e.g., having a "good" thought to cancel out a "bad" thought)
people feel driven to do to reduce distress. Often compulsions are intended
to reduce distress related to obsessions (e.g., repetitive washing in
response to concerns about germs and disease). While periodic negative
thoughts are a common experience for all people, OCD is defined by the
related significant distress and life interference that results from these
What Are Obsessions?
Obsessions are ideas, thoughts, images, or impulses that are senseless
and "get in the way." They continue even though a person may try to ignore
or forget about them. They are experienced as unpleasant and unwanted
and may provoke anxiety, guilt, shame, or other uncomfortable
The most common obsessions are concerns that objects or other people
might be “contaminated” by contact with germs, disease, dirt, chemicals,
or some other source. The feeling of contamination is accompanied
by an urge to wash or to clean. Other obsessions focus on fears that doors
or windows have been left unlocked, appliances have been left on, important
papers have been thrown away, mistakes have been made, and so
Frightening thoughts about burglary, fire, and other losses often accompany
these fears, forming part of the obsessive ideas. Some obsessive
thoughts concern accidents or unfortunate events that might occur unless
one superstitiously repeats particular actions or thoughts to prevent
the disaster. Other obsessions take the form of unwanted urges or impulses
to do something harmful, such as to stab one’s child with a kitchen
knife. Some people experience horrific or upsetting images having to do
with religious figures.
Obsessions can take many forms. Ordinary people are concerned by
many of the ideas, thoughts, images, or impulses underlying obsessive
fears. Most of us are concerned about AIDS and other diseases, and
about harmful chemicals in the environment. We are careful not to leave
hot appliances near materials that might catch fire. We periodically experience
odd impulses or form upsetting images. However, for those with
OCD, the fear and guilt or other unpleasant emotions are out of proportion
to the actual risk of danger or harm, driving them to carry out compulsions to rid themselves of the worry.
What Are Compulsions?
Compulsions, also called rituals, are usually actions that are repeated,
but sometimes are thought patterns that are performed to rid oneself
of a disturbing obsession. Rituals are usually carried out according to
certain rules or in a rigid fashion and are clearly excessive. The person
recognizes that the rituals are not reasonable but feels unable to
control them. Most compulsions are logically related to the type of
obsessive ideas they attempt to reduce or prevent, although this is not
always true. Because they temporarily reduce discomfort, rituals become
habitual, and the person with OCD often has difficulty controlling
Examples of compulsions include hand-washing, showering, or
cleaning to remove “contamination”; checking to prevent feared dangers
such as theft, fire, or loss of important things; repeating actions
or thoughts to prevent a catastrophic event from happening; having
to arrange objects in a particular way before beginning an activity; or
needing repeated reassurance from others that a feared event has not
or cannot happen. Some compulsions are performed mentally without
any behavioral manifestation. Examples include praying to relieve
guilt about an unwanted idea and repeating phrases or images
in one’s mind to prevent a catastrophe.
Those who suffer from obsessions and compulsions vary widely in their
personality characteristics, life circumstances, and the degree to which
their lives are disrupted by these symptoms. Thus, it is difficult to make
general statements about their habits. Some researchers have suggested
that those with OCD tend to come from more perfectionistic and possibly
more moralistic upbringings. They are more concerned with avoiding mistakes
than are people who do not get so anxious.
Many OCD sufferers appear to overestimate the risk involved in
their obsessive concern, and some dislike taking even small risks of
any type. Many doubt their own decision-making ability and request
reassurance from others to confirm their choices. On the other hand,
many people with OCD do not exhibit these traits, but appear to be
quite normal in their social, recreational, and work lives.
While obsessions and related compulsions can take a near infinite
number of forms, there are several symptom patterns that are regularly
seen in OCD. A common type of OCD involves contamination
obsessions and associated washing and/or cleaning compulsions. Another
variation of OCD symptoms involves obsessions about bad
things happening (e.g., leaving something cooking on the stove and
inadvertently causing a fire). To prevent harm from occurring, the individual
becomes stuck respectively checking. Other people with OCD
experience distress when things are not ordered or arranged in a particular
manner, while others are troubled by constant concerns about
morality and the implications it might have for their behavior. The
heterogeneous nature of OCD, and its frequent occurrence with anxiety,
depression, and other problems, can present challenges to its
identification by health and mental health professionals.
There is no clear understanding of what causes OCD, although research
over the last several decades indicates that multiple factors are
involved. There is a significant genetic component with people closely
related to those with OCD being more likely to have or develop the
condition. Some models of the development of OCD emphasize differences
in specific brain neurotransmitters and abnormalities in specific
brain circuits. In behavioral models of OCD, specific types of
learning and conditioning experiences are emphasized. The cognitive
model of OCD emphasizes the common nature of negative intrusive
thoughts and the important role the misappraisal of these thoughts
has in the condition’s development. For example, having a thought
that a loved one could be in a car accident can be understood as a
passing negative thought and is easily dismissed. Alternatively, the
thought could be inaccurately appraised as an indication that an accident
is more likely to occur, in which case one would be obligated to
prompt the person to drive carefully. The latter appraisal, understood
as driven by specific types of dysfunctional beliefs, is believed to play
an important role in OCD development and the continuation of
A number of treatments help. One includes a specific form of behavior
therapy, exposure and response (ritual) prevention (ERP). OCD
has also been effectively treated by a form of cognitive-behavior therapy
focused on how negative intrusive thoughts are understood. Most
mental health professionals and scientists with expertise in OCD see
ERP as a critical treatment for the condition. ERP first involves careful
identification of the individual’s obsessions and the related distress-
reducing compulsions or avoidance behaviors. Often people’s
obsessional concerns and compulsions are highly idiosyncratic. Once
obsessions and related compulsions are understood, an exposure hierarchy
is structured. The exposure hierarchy is a listing of less difficult
to more difficult OCD-related activities. For example, for a
person with contamination concerns, touching and not washing
might begin with a table used by others at home and progress to
touching a sink in a public restroom. It is very important that during
each exposure exercise the individual be guided to continue the activity
until they experience a significant reduction in anxiety or distress.
Individuals willing to complete this treatment often experience significant
symptom reduction in several weeks.
Unfortunately, many health and mental health professionals are not
expert in the identification of OCD, or in its treatment using ERP.
Professional organizations such as ABCT provide listings of practitioners
expert in cognitive-behavioral therapy, including providers
who specialize in treating OCD. You can visit the ABCT website and
click on "Find a CBT Therapist" to find treatment providers in your
area who treat OCD (http://www.abct.org/Help/?m=mFindHelp
&fa=dFindHelp). Additionally, there are several international, national,
or regional organizations that provide information about
health care professionals' expertise in treating OCD, information
about OCD broadly, and advice on screening OCD treatment
providers. The International OCD Foundation provides information
about OCD and related problems and information on where to find
treatment (https://iocdf.org/about-ocd/treatment/). The Anxiety
and Depression Association of America also provides information
about OCD and its treatment (https://www.adaa.org/sites/default/files/Relief-from-OCD.pdf). Beyond OCD
is a provider of information and treatment for OCD in Chicago and
the Midwest (http://beyondocd.org/).
For more information or to find a therapist:
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