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Clinical Case Studies
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Treatment of Obsessive Thoughts and Cognitive Rituals Using Exposure and Response Prevention

A Case Study

Jonathan S. Abramowitz

Mayo Clinic

This case study describes the application of cognitive-behavioral therapy by exposure and response prevention (EX/RP) to a young man with obsessive-compulsive disorder (OCD) involving primarily obsessional thoughts and mental rituals. Although patients with primarily cognitive OCD symptoms have been previously considered treatment resistant, novel approaches to EX/RP have been developed and validated. Successful treatment of such symptoms requires a thorough and informed assessment. The theoretical and empirical basis for these procedures is described, along with a cognitive-behavioral analysis of the problem. The course of treatment, use of assessment data, and recommendations to clinicians are also discussed.

Key Words: obsessive-compulsive disorder • mental rituals • cognitive-behavioral theory • obsessional thoughts • case study

Clinical Case Studies, Vol. 1, No. 1, 6-24 (2002)
DOI: 10.1177/1534650102001001002


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M. R. Ritter and H. Hazlett-Stevens
The Use of Exposure and Ritual Prevention in the Treatment of Harm Obsessions With Covert Compulsions
Clinical Case Studies, December 1, 2006; 5(6): 455 - 476.
[Abstract] [PDF]