title: Cognitive-behavioural approach to understanding obsessional thinking.
abstract: BACKGROUND
  Obsessional ruminations (obsessions without any accompanying overt compulsive behaviour) were previously considered especially difficult to treat.
  
  
  METHODS
  Cognitive-behavioural theory regarding obsessional problems is discussed. Strategies for therapy developed on the basis of this theory are reviewed.
  
  
  RESULTS
  The cognitive-behavioural theory of obsessive-compulsive disorder proposes that obsessional problems occur as a consequence of the particular meaning or significance which patients attach to the occurrence and/or content of intrusive thoughts. When intrusions are interpreted (appraised) as indicating increased personal responsibility, this results in both distress and the occurrence of neutralising behaviour. Cognitive-behavioural treatment seeks to change responsibility beliefs and appraisals, and thereby reduce distress and eliminate neutralising responses which usually occur as covert neutralising (mental rituals). Evidence is emerging for the success of therapy developed on this theoretical basis.
  
  
  CONCLUSIONS
  Recent developments in the psychological conceptualisation of obsessional ruminations have improved the prospects for successful therapy.
authors.affiliation: University of Oxford Department of Psychiatry.
authors.forename: P M
authors.initials: PM
authors.lastname: Salkovskis
authors.forename: E
authors.initials: E
authors.lastname: Forrester
authors.forename: C
authors.initials: C
authors.lastname: Richards
mesh_terms: D001008:Anxiety Disorders / Q000209:etiology / Q000628:therapy; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D006801:Humans; D009770:Obsessive Behavior; D009771:Obsessive-Compulsive Disorder / Q000628:therapy*; D013850:Thinking; D016896:Treatment Outcome