title: Efficacy of cognitive-behavioral therapy for obsessive-compulsive disorder.
abstract: Cognitive-behavioral therapy (CBT), which encompasses exposure with response prevention (ERP) and cognitive therapy, has demonstrated efficacy in the treatment of obsessive-compulsive disorder (OCD). However, the samples studied (reflecting the heterogeneity of OCD), the interventions examined (reflecting the heterogeneity of CBT), and the definitions of treatment response vary considerably across studies. This review examined the meta-analyses conducted on ERP and cognitive therapy (CT) for OCD. Also examined was the available research on long-term outcome associated with ERP and CT. The available research indicates that ERP is the first line evidence based psychotherapeutic treatment for OCD and that concurrent administration of cognitive therapy that targets specific symptom-related difficulties characteristic of OCD may improve tolerance of distress, symptom-related dysfunctional beliefs, adherence to treatment, and reduce drop out. Recommendations are provided for treatment delivery for OCD in general practice and other service delivery settings. The literature suggests that ERP and CT may be delivered in a wide range of clinical settings. Although the data are not extensive, the available research suggests that treatment gains following ERP are durable. Suggestions for future research to refine therapeutic outcome are also considered.
authors.affiliation: Fordham University, Bronx, NY, USA. Electronic address: mckay@fordham.edu.
authors.forename: Dean
authors.initials: D
authors.lastname: McKay
authors.affiliation: McGill University, Montreal, Quebec, Canada.
authors.forename: Debbie
authors.initials: D
authors.lastname: Sookman
authors.affiliation: Biobehavioral Institute, Great Neck, NY, USA.
authors.forename: Fugen
authors.initials: F
authors.lastname: Neziroglu
authors.affiliation: Harvard University & Massachusetts General Hospital, Boston, MA, USA.
authors.forename: Sabine
authors.initials: S
authors.lastname: Wilhelm
authors.affiliation: University of Cape Town, Cape Town, South Africa.
authors.forename: Dan J
authors.initials: DJ
authors.lastname: Stein
authors.affiliation: University of Melbourne, Melbourne, Australia.
authors.forename: Michael
authors.initials: M
authors.lastname: Kyrios
authors.affiliation: University of Dundee, Dundee, UK.
authors.forename: Keith
authors.initials: K
authors.lastname: Matthews
authors.affiliation: NIHR Specialist Biomedical Research Centre for Mental Health at the South London and Maudsley NHS Foundation Trust and The Institute of Psychiatry, King׳s College London, UK.
authors.forename: David
authors.initials: D
authors.lastname: Veale
mesh_terms: D015928:Cognitive Behavioral Therapy / Q000592:standards*; D006801:Humans; D009771:Obsessive-Compulsive Disorder / Q000628:therapy*
keywords: Cognitive therapy; Exposure with response prevention; Meta-analysis; Obsessive–compulsive disorder; Treatment adherence