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Protocol for Repetitive Transcranial Magnetic Stimulation with Symptom Provocation to Treat Obsessive-compulsive Disorder
Published on: November 25, 2025
Treatment of obsessions: a randomized controlled trial
Maureen L Whittal1, Sheila R Woody, Peter D McLean
1University of British Columbia Hospital, Vancouver, BC V6T2A1, Canada. whittal@interchange.ubc.ca
Behaviour Research and Therapy
|December 9, 2009
Summary
Cognitive behavioral therapy (CBT) and stress management training (SMT) effectively treat obsessions, significantly reducing symptoms and improving functioning. Both treatments demonstrated robust, enduring effects, challenging previous beliefs about treatment resistance.
Area of Science:
- Psychology
- Psychiatry
- Clinical Psychology
Background:
- Obsessions, often without prominent compulsions, are considered difficult to treat.
- Cognitive behavioral methods offer a potential avenue for managing these symptoms.
Purpose of the Study:
- To evaluate the efficacy of Rachman's cognitive behavioral method for treating obsessions.
- To compare cognitive behavioral treatment (CBT) against stress management training (SMT) and a waitlist control.
Main Methods:
- 73 adults with obsessions were randomized into CBT, SMT, or waitlist groups.
- Symptom severity (YBOCS), cognitions, depression, and social functioning were assessed.
- One-year follow-up data were collected to assess long-term outcomes.
Main Results:
- Both CBT and SMT significantly reduced YBOCS scores, OCD-related cognitions, and depression compared to the waitlist.
- Large and comparable symptom reductions were observed for both active treatments (CBT and SMT).
- While CBT showed minor short-term advantages, differences between CBT and SMT faded by the one-year follow-up.
Conclusions:
- Cognitive behavioral treatment and stress management training are effective for treating obsessions.
- These findings challenge the notion that obsessions are inherently resistant to psychological interventions.
- Both treatments yield robust and lasting improvements in symptoms and functioning.
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