Enhancing Exposure and Response Prevention Treatment in an Individual With Relationship Obsessive-Compulsive...

Obsessive-compulsive disorder (OCD), characterized by repetitive thoughts (obsessions) and behaviors (compulsions), is a leading cause of health-related disability in the world. Various kinds of obsessions and compulsions exist and tend to co-occur in dimensions (e.g., doubting/checking, symmetry/ordering, contamination/cleaning). Cognitive-behavioral therapy (CBT) consisting of exposure and response (ritual) prevention (ERP) is arguably the safest and most efficacious treatment for OCD. ERP involves exposing OCD patients to stimuli that provoke obsessions while coaching them to not ritualize. There is increasing evidence to suggest that the specific symptom dimensions of OCD have unique correlates and different responsiveness to ERP. Although many patients respond to ERP, only a subset achieve minimal symptoms. Given the challenges that may arise in ERP treatment of specific OCD dimensions, there has been increasing interest in examining OCD with relationship-related themes that focus on the romantic relationship or partner. In this case report, we present a case of an adult with OCD containing relationship themes and highlight ERP adaptations we utilized to improve his treatment course.