COGNITIVE THERAPY AND EXPOSURE IN-VIVO IN THE TREATMENT OF OBSESSIVE-COMPULSIVE DISORDER

The present study is the first controlled study that evaluates the eff ects of cognitive therapy along the lines of Beck (1976) [Cognitive th erapy and the emotional disorder. New York: International University P ress] and Salkovskis (1985) [Behaviour Research and Therapy, 23, 571-5 83] in obsessive compulsive disorder (OCD) and compares these effects with those of self-controlled exposure in vivo with response preventio n. Seventy-one patients were randomly assigned to either cognitive the rapy or exposure in vivo. In each treatment condition seven patients d ropped out. Both treatments consisted of 16 sessions. Cognitive therap y as well as exposure in vivo led to statistically significant improve ment. Multivariate significant differences suggesting a superior effic acy of cognitive therapy in comparison to exposure in vivo on the obse ssive compulsive measures and on the measures for associated psychopat hology. However, no univariate differences were found. Further, in bot h treatment conditions a considerable percentage of the patients was r ated as ''recovered''. Significantly more patients were rated as ''rec overed'' in the cognitive therapy. The results show that this form of cognitive therapy is an effective treatment for OCD and suggest that c ognitive therapy may be even more effective than exposure in vivo.