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Using an Acceptance and Commitment Therapy Approach When Exposure and Cognitive Therapy Become Rituals in the
Jennifer L Buchholz1, Jonathan Abramowitz1
1Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill Chapel Hill, NC.
Abstract:
Exposure and response prevention (ERP) for obsessive-compulsive disorder (OCD) is often highly effective, yet some patients experience relapses following a seemingly successful course of treatment. In this article we describe the conceptual basis of ERP, and then present a client who relapsed after seemingly achieving substantial improvement following 11 sessions of ERP. Likely reasons for the relapse and strategies for enhancing ERP to achieve better long-term treatment outcomes are discussed from the perspective of acceptance and commitment therapy (ACT). These strategies mainly apply to the implementation of situational (in vivo) and imaginal exposure therapy, but also include suggestions for optimizing the use of cognitive therapy for OCD.
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