مواجهه درمانی برای اختلال وسواس: یک رویکرد یادگیری بازدارندگی بهینه سازی

This paper is part of a series that explores the application of different therapies to a case of obsessive–compulsive disorder (OCD). It describes the application of an optimizing inhibitory learning approach to exposure with response prevention for OCD. This paper covers the basic theory and applications of the optimizing inhibitory learning approach for OCD and provides a detailed case conceptualization. Specific examples illustrate how to conduct exposure in a manner that enhances inhibitory learning with the goal of enhancing long-term exposure therapy outcomes. The goal of this paper is to familiarize clinicians with the function that inhibitory learning serves in exposure treatment and how to apply the research findings to maximize inhibitory learning in the context of treating OCD.

Despite substantial research demonstrating the efficacy of cognitive-behavioral therapy incorporating exposure with response prevention (ERP) in the treatment of obsessive compulsive disorder (OCD), quantitative reviews have concluded that some patients remain symptomatic after this intervention (Abramowitz, 1998). In this paper, we present a promising approach to improving OCD treatment outcomes. Specifically, we show how to apply developments in basic learning, memory, and extinction research to the implementation of exposure therapy for OCD. We draw on Monica׳s case to demonstrate concretely how to apply this methodology to optimize inhibitory learning – the type of learning that occurs during exposure therapy (Craske et al., 2008 and Craske et al., 2012).