Exposure Therapy in OCD: Is There a Need for Adding Cognitive Elements?

Although exposure-based psychotherapies are an effective and widely used treatment for obsessive–compulsive disorder (OCD), the past 15 years has seen the introduction and incorporation of cognitively based models and treatments of this disorder. This chapter reviews research supporting the efficacy of exposure and response prevention (ERP) for OCD, as well as shortcomings of ERP that led to the creation of cognitive models of OCD. Outcome literature examining the efficacy of cognitively enhanced behavioral therapies in comparison to ERP will also be examined. Although treatment outcomes with ERP alone are largely equivalent to cognitively focused treatments, there may be specific presentations or settings that may be better or worse suited to the addition of cognitive elements to exposure.