Behavior Therapy （CBT） in the treatment of OCD认知行为疗法（CBT）在治疗强迫症课件.ppt

Setting Practice Goals I will expose myself to X, without doing Y Put practice goals in writing Ask the 80% question—”If I practiced this goal 10 times, would I likely be successful 8? Use Subjective Units of Distress (SUD) ratings to guide practice goals Strive to achieve but be forgiving Notice small gains Set practice goals each session Techniques to assist E/RP by Lee Baer, Ph.D. Practice with your helper a) discuss your goals openly with helper b) accept encouragement for even partial accomplishments c) ask any reasonable question (not for reassurance, and trust their opinion) d) do not argue or get angry with your helper Techniques to assist E/RP You will feel anxiety if you are doing the exposures and response prevention correctly (but it will be less than feared) Keep reminders hand (index cards) Reward yourself for success Visualize your long-term goals Let obsessions pass through your mind (do not try and block them—due to rebound) Techniques to assist E/RP Maintain standards in E/PR (avoid keeping fingers crossed, saying a prayer or smoking a cigarette to reduce anxiety during an exposure) Hints for RP—break down goals into small steps Use Audiotapes (for idiosyncratic ones) and Videotapes to intensify exposures Set aside “worry time” for obsessions In working with kids, parents must be involved—a reward system can be helpful Treatment of OCD in children Assessment of OCD: Individualized diagnostic assessment: review of OCD symptoms r/o co-morbid disorders (depressive or disruptive disorders, other spectrum dx.’s) review of psychosocial factors Treatment of OCD in children Treatment of choice for OCD in children: is a combined treatment (CT) approach-- CBT SSRI’s Expert consensus treatment guidelines for 1st line treatments Prepubescent children: CBT (mild or severe OCD) Adolescents: CBT for milder OCD; CBT SRI (or SRI alone) for severe OCD Treatment of OCD in children CBT alone CBT is a remarkably effective durabl