Cognitive behavioral therapy (CBT) is the most researched form of mental health therapy there is.
A basic facet of CBT is that therapists can use three things to understand their patients, the way people think, feel, and behave. Further, the goal of this therapy is to help people make changes in their behaviors, thoughts, and feelings.
CBT therapists have many ways to help their patients examine and challenge their thoughts. One is a thought record (see Appendix A). The thought record allows people to document and examine their thoughts, to see what types of distortions may exist, and to come up with ways to challenge these thoughts.
Another technique is to challenge thoughts directly. If a patient says, “thinking something is as bad as doing it,” the therapist may say something like, “I hope my car explodes today when I get into it.” Then they may walk out to the therapist’s car, and the patient can watch the therapist get into the car without it exploding, therefore challenging the notion that thinking something makes it happen.
Or, a therapist may request that the patient convince the therapist that the patient is correct in his or her thinking. However, this often backfires on the patient, who begins to see that the therapist’s challenges and questions to his or her way of thinking are more based in reality than the person’s obsessions are.
CBT therapists also assist people in recognizing that experiencing a feeling does not mean that this is the only way that they can feel about the situation. For example, some people fear elevators, and other people enjoy them. But these feelings are not set, they can be changed. In fact, the person who fears the elevator may have enjoyed elevators until he or she got stuck in one a year ago. If a person’s feelings can change from safety to fear, then it is possible for the feeling to return to safety again.
Finally, the focus is also on behaviors. A CBT therapist assesses what behaviors a person performs that could merit therapy. The therapist often suggests that a person modify his or her actions to get different results in his or her everyday life. For example, the therapist may do role-plays with a socially anxious person to teach that person new ways to interact with people, such as adding more eye contact, speaking louder, or not slouching.
Combining the areas of thoughts, feelings, and behaviors allows a CBT therapist to cover almost everything that can be a beneficial change for someone with OCD. Patients have a greater chance for success in dealing with their anxiety when all of these areas are targeted.