OCD is a neurological disorder involving obsessions (persistent thoughts) and compulsions (repetitive behaviors or rituals). Usually the compulsion helps to decrease the anxiety associated with the thoughts. Decades of scientific research regarding OCD has contributed to the development of the EX/RP program which has received the most scientific evidence in treating OCD to date.
The introductory phase of EX/RP involves a detailed explanation of OCD, collecting information regarding a client’s specific OCD history, triggers, obsessions, and compulsions, and discussing how to self-monitor outside of session.
Together with their therapist, clients work on a hierarchy of situations that would cause anxiety and create in vivo (real life) exposures and imaginal (in your imagination) exposures to help clients confront the distressing situation and not engage in compulsions. This helps clients realize that anxiety can be reduced without the compulsion and also that their fear related to the obsession is not actually a concern. Studies show that these two components (in vivo and imaginal) are essential in a successful outcome.