© 2003 Oxford University Press
Overview of Treatments for Obsessive-Compulsive Disorder and Spectrum Conditions: Conceptualization, Theory, and Practice
From the Anxiety Disorders Center at The Institute of Living in Hartford, CT.
Contact author: Nicholas Maltby, PhD, Anxiety Disorders Center, The Institute of Living, 200 Retreat Avenue, Hartford, CT 06106. E-mail: nmaltby{at}harthosp.org.
This paper presents an overview of obsessive-compulsive disorder (OCD) and the obsessive-compulsive spectrum disorders (OCSDs) by outlining the major arguments for and against the spectrum construct. Cognitive, behavioral, and biological models are reviewed, as are assessment strategies for adults and children. Treatment options for OCD are critically evaluated, and it is argued that exposure and ritual prevention (ERP) has the best support as the first-line psychological treatment. Suggestions for overcoming the most common obstacles faced during treatment are provided. In addition, strategies for dealing with partial or nonresponse or treatment refusal are discussed. Stepped-care models are presented as a potential method of addressing the problems caused by the expense and time commitment of existing treatments. [Brief Treatment and Crisis Intervention 3:127144 (2003)]
KEY WORDS: obsessive-compulsive disorder, obsessive-compulsive spectrum, reviews, cognitive-behavioral therapy, pharmacotherapy