Coming from the perspective of a behaviorist psychologist, how would he/she recommend that Obsessive Compulsive Disorder (OCD) be treated, and would he/she be able to foresee any strengths or weaknesses in the treatment plan?
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A behaviorist psychologist might use two different forms of Cognitive-Behavioral Therapy to treat patients with Obessive Compulsive Disorder (OCD), and those behavioral treatments are Cognitive Therapy (CT) and Exposure and Response Prevention (ERP). While they are two different therapies, most psychologists will use them in combination to treat a patient. While both have been shown to be effective over a long period of time, either used separately or in combination, both therapies also have their downsides. As we are limited in space, below is a discussion of CT, it's uses and why it still has some weaknesses.
CT works based on the idea that those with OCD "become anxious about their thoughts (or obsessions)" once they begin to see their "thoughts as dangerous and likely to occur" ("Treatments for OCD: Cognitive-Behavioral Therapy"). For example, individuals who are afraid to leave the house with the stove on will begin seeing their own behavior as debilitating if their behavior leads them to return to the house repeatedly to check the stove, preventing them from leaving at all. Through CT, patients are asked to "interpret their obsessions" and consider "what they believe or assume to be true about them, what their attitude is toward them and why they think they have these obsessions" ("Treatments for OCD"). The therapist then helps the patients "re-evaluate [their] beliefs" concerning "potential consequences of engaging or not engaging in compulsive behavior" as a means of trying to phase out the behavior ("Treatments for OCD"). The therapy can involve having patients create "thought records" in which they record every detail they can about their specific obsessions, including any thoughts related to the obsessions.
Very few studies have actually been performed to prove the effectiveness of CT; however, those that have been done have shown it to be more affective in dealing with the anxiety related to OCD than just medications. Regardless, from a behavior therapist's standpoint, there certainly are some drawbacks to the therapy. Dr. Key Sun points out in his article published in Psychology Today, that one drawback concerns the fact the therapy confuses the negative anxiety-producing feelings with being a cause of the obsessive behavior rather than of a symptom of the behavior. Dr. Sun argues that feelings of "low-self esteem, self-blame and self-criticism, negative predictions, unpleasant memories, erroneous interpretations of experiences, etc." are all a symptom of OCD and not necessarily the cause of OCD behavior ("Four Drawbacks to Cognitive Therapy"). So, trying to address the behavior by simply trying to eliminate a symptom will fall short of a therapist's goal. Dr. Sun also points out that some with OCD have it as a result of a realistic perception of negative experiences they have had, such as "sexual or physical abuse"; therefore, using "cognitive-restructuring exercises" to try and change realistic, negative emotions would actually not "deal with the true problem" ("Four Drawbacks"). Finally, he further points out that even "positive self-evaluations," as opposed to negative ones, can be just as "dysfunctional and maladaptive" as negative ones because even positive self-evaluations can be shown to be "characterized by inaccuracy and bias" ("Four Drawbacks"). Hence, while CT can be shown to help, usually over an extended period of time, it can also be shown to be based on faulty principles that a behavior therapist should consider when evaluating whether or not CT will benefit a patient with OCD.
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