Treatment-resistant OCD, inflated responsibility, and the therapeutic relationship: two case examples

Area of Science:

• Psychology
• Clinical Psychology
• Psychotherapy

Background:

• Obsessive-compulsive disorder (OCD) is often treated with Cognitive Behavioral Therapy (CBT).
• Treatment-resistant OCD presents significant challenges.
• Inflated responsibility is a key cognitive feature in OCD.

Observation:

• An unconventional intervention, Therapist Assumes Responsibility (TAR), is presented.
• TAR parallels experimental analyses of responsibility in OCD.
• Two case studies illustrate the application of TAR.

Findings:

• The therapist-client relationship is central to TAR in OCD treatment.
• Clients learn to trust others and accept insecurity through TAR.
• TAR addresses inflated responsibility and reassurance seeking.

Implications:

• Integrating an interpersonal factor into CBT for OCD may enhance treatment efficacy.
• The client-therapist relationship can be a therapeutic tool for OCD.
• Reassurance seeking in OCD may stem from interpersonal factors.