Cognitive-behavioral treatment of obsessions

Three patients with obsessive-compulsive disorder whose major complaints were obsessional thoughts with cognitive neutralization as opposed to overt rituals were treated with a cognitive-behavioral package. Cognitive neutralization involves both cognitive rituals and a variety of less ritualized coping strategies all designed to remove the thought and decrease discomfort. In a departure from earlier case studies, the patients were treated in a multiple baseline design across subjects. All three patients reported decreased discomfort and improved their professional and/or interpersonal functioning. Gains were maintained at follow-up (8 to 11 months).