Category: Obsessive Compulsive and Related Disorders


Institute 9 - The Problem of Obsessions: How to Boost CBT Effectiveness With Self-Regulatory Strategies

Thursday, November 16
1:00 PM - 6:00 PM
Location: Sapphire Ballroom I, Level 4, Sapphire Level

Keywords: OCD (Obsessive Compulsive Disorder) | Emotion Regulation | Cognitive Schemas / Beliefs
Presentation Type: Institutes
Level of Familiarity: Moderate to Advanced

In many respects, the treatment of obsessive compulsive disorder (OCD) has been one of the great success stories in cognitive behavior therapy (CBT). Most individuals experience clinically significant symptom reduction when treatment includes exposure and response prevention (ERP), although even then, only one-quarter of treatment completers attain symptom-free status. Moreover, the effectiveness of conventional CBT declines when the OC symptom presentation is predominantly obsessional and overt compulsions are less prominent. This institute presents a new perspective on treatment of obsessive thinking based on self-regulatory strategies derived from research on mental and emotion control. We begin by delineating the boundaries and limitations of conventional ERP approaches to obsessions. A cognitive-behavioral self-regulatory understanding of obsessions is presented along with a case formulation treatment plan based on the CB self-regulation framework. Specific adjunctive interventions are described such as normalization of unwanted thoughts, meaning detoxification, letting go of excessive control, and cognitively based response strategies. Case illustrations and role-plays as well as an interactive didactic teaching approach will explain how to apply these self-regulatory interventions within the therapy session. Throughout emphasis is placed on how to integrate self-regulatory intervention with conventional CBT in order to augment the effectiveness of established approaches to treating obsessions.

Earn 5 continuing education credits

Learning Objectives:

Recommended Reading: Rachman, S. (2003). The treatment of obsessions. Oxford: Oxford University Press.
Wegner, D. (2011). Setting free the bears: Escape from thought suppression. American Psychologist, 66, 671-680.
Clark, D.A. (2004). Cognitive-behavioral therapy for OCD. New York: Guilford.
Rachman, S., Shafran, R., Coughtrey, A.E., & Radomsky, A.S. (2015). Oxford guide to the treatment of mental contamination. Oxford: Oxford University Press.
Rassin, E. (2005). Thought suppression. Amsterdam: Elsevier.

David A. Clark

Professor Emeritus
University of New Brunswick


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Adam S. Radomsky

Professor and Research Chair in Anxiety and Related Disorders
Concordia University


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Institute 9 - The Problem of Obsessions: How to Boost CBT Effectiveness With Self-Regulatory Strategies

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