Trichotillomania is a behavioral problem, and is often referred to as a habit disorder, but it is important to consider the cognitive and emotional components of the behavior. Current treatment recommendations include a traditional behavioral approach (Habit Reversal Training; HRT) combined with an approach that addresses the cognitive and…

Despite being the most effective treatment available, as many as one third of patients who receive exposure and response prevention (ERP) for obsessive-compulsive disorder (OCD) do not initially respond to treatment. Recent research suggests that the n-methyl d-aspartate (NMDA) receptor partial agonist D-Cycloserine (DCS) may speed up the course…

Obsessive-compulsive disorder (OCD) is a leading cause of health-related disability. There are two evidence-based treatments for OCD, pharmacotherapy and cognitive-behavioral therapy consisting of exposure and response prevention (EX/RP). Although effective, outcome from both treatments is often limited by patient lack of adherence to the…

Traditional cognitive-behavioral interventions for trichotillomania have had modest acute treatment outcomes and poor maintenance of gains over time. Techniques adopted from dialectical behavior therapy (DBT) can potentially enhance treatment outcomes by specifically addressing issues of impulsivity, emotion regulation, and distress tolerance. In…

This paper offers a commentary on the articles in the special series on cognitive behavior therapy with older adults (Carmin, 2012-this issue), noting the commonalities found across discussions of diagnostic interviewing and cognitive-behavioral assessment and treatment for late-life insomnia, depression and suicide risk, PTSD, and OCD. These case…

This article outlines the conceptual and empirical basis for an inference-based approach (IBA) to treating obsessive-compulsive disorder (OCD). The IBA considers that in most cases the obsessional process begins with an initial doubt (e.g., "Maybe my hands are not clean"; "Perhaps the door was not locked"; "There's a chance I made an error"; "I…

The objective of this study was to facilitate the bidirectional communication between researchers and clinicians about the treatment of childhood anxiety disorders, including obsessive-compulsive disorder. Forty-four children were assessed before and after cognitive behavioral treatment with the parent versions of the Spence Child Anxiety Scale…

Massed exposure has gained acceptance as an effective method to treat anxiety disorders. When using this intervention in patients presenting with more than one anxiety disorder, specific treatment options need to be discussed. Should exposure be applied in sequential order for each of the comorbid disorders? Or can exposure sessions also be…

This paper is part of a case series illustrating the application of different therapies to a case of obsessive-compulsive disorder (OCD). It describes the hypothetical application of Acceptance and Commitment Therapy (ACT). This paper covers the philosophy and basic research on language and cognition that inform ACT. It also provides an ACT-based…

Contemporary cognitive treatment of obsessive-compulsive disorder (OCD) dates back to 1985, and rests on the premise that infrequent unwanted intrusions are essentially universal. As such, it is not the intrusion that is the focus of treatment but rather the interpretation or appraisal placed upon the intrusion. A number of cognitive domains are…

Very little is known regarding the efficacy of pharmacological and psychosocial treatments for children and adults with trichotillomania (TTM). Given this dearth of information, the present investigation sought to examine the treatment practices of members of the nationally recognized Trichotillomania Learning Center-Scientific Advisory Board…

Cognitive therapy for OCD is an empirically validated alternative to the more widely used and validated behavioral therapy for OCD. The cognitive approach is based on the premise that belief systems contribute importantly to the development and maintenance of all types of OCD. By identifying and challenging maladaptive thoughts, beliefs, and core…

The present article comments on the case conference presented in this issue, namely, Himle and Franklin's (Himle & Franklin, 2009) exposure and response prevention (ERP); Chosak and colleagues' (Chosak, Marques, Fama, Renaud, & Wilhelm, 2009) cognitive therapy (CT); and (Twohig, 2009) Acceptance and Commitment Therapy (ACT). Two questions are…

This article presents the case of a 51-year old woman with obsessive-compulsive disorder. "Caroline" reported obsessions of harming people secondary to spreading her "bad energy," which is experienced as dust on her hands and in her mouth. To prevent harm coming to others she mentally "vacuums" the dust, creates…

Obsessive-compulsive disorder (OCD) is an illness characterized by intrusive and distressing thoughts, images, or impulses (i.e., obsessions) and by repetitive mental or behavioral acts (i.e., compulsions) performed to prevent or reduce distress. Efficacious treatments for OCD include psychotropic medications and exposure and response prevention…