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(p. 67) Cognitive-behaviour therapy for obsessive-compulsive disorder 

(p. 67) Cognitive-behaviour therapy for obsessive-compulsive disorder
(p. 67) Cognitive-behaviour therapy for obsessive-compulsive disorder

Victoria Bream

, Fiona Challacombe

, Asmita Palmer

, and Paul Salkovskis

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date: 26 January 2021

This chapter guides the reader through the process of eliciting a shared understanding of obsessive-compulsive disorder (OCD), working collaboratively with the client—a cornerstone of the cognitive-behaviour therapy (CBT) approach. Step-by-step guidance includes examples of therapy dialogue for key aspects of this process. The emphasis in CBT is typically focussed on the here-and-now; this chapter emphasizes how to elicit a maintenance formulation that focusses on how the problem operates in day-to-day life. There is guidance on how much developmental information to include and how much emphasis to place on this. The chapter breaks down different stages of the therapy process, beginning with how to develop a credible alternative explanation to the person’s existing beliefs about their OCD—building up a ‘theory A/B’. This forms the basis for the remainder of the treatment, which essentially involves the client engaging in a process of putting the two theories to the test, often using behavioural experiments. A range of metaphors is described.

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