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 Cognitive-behavioral therapy is a treatment for OCD that uses two scientifically based techniques to change a person’s behavior and thoughts: exposure and response prevention (ERP) and cognitive therapy. CBT is conducted by a cognitive-behavioral therapist who has special training in treating OCD.

Most CBT treatment is conducted at a therapist’s office so client can practice at home or in between ERP  sessions. If your OCD is severe, you need to have more frequent sessions usually daily. Not all mental health professionals are trained in ERP therapy, so it’s important to find one who is and practicing same.

One key to knowing whether you have found an appropriate ERP therapist is if the therapist encourages you to engage in exposure exercises during your sessions either in the office or online. This helps you engage in more exposures outside. Simply speaking about doing them in the office is less effective than getting started with the actual exposures. The ultimate goal of therapy is to translate exposure to the real world, where you can resist your compulsions and where you can embrace uncertainty rather than fear it.

Exposure Therapy
The psychotherapy of choice for the treatment of OCD is exposure and response prevention (ERP), which is a form of CBT. In ERP therapy, people who have OCD are placed in situations where they are gradually exposed to their obsessions and asked not to perform the compulsions that usually ease their anxiety and distress. This is done at your pace. Your therapist is the right person to decide intensity of exposure. The first step is for you to describe all of your obsessions and compulsions in list down manner. Then you and the therapist will arrange them in a list, ordering them from things that don’t bother you much to things that are the most frightening. Next, the therapist will ask you to face your fear of something on your list, starting with the easiest. Let’s say you have an obsessive fear of germs in public places, and that fear is pretty low in how much it scares you. Your therapist will design a task for you that exposes you to that fear. Your task might for you to touch a public doorknob. Here’s where the response-prevention part comes in. If your usual response is to wash your hands immediately after touching the doorknob, the therapist would ask you to wait before you wash your hands. As you repeat this exposure task, the therapist will ask you to wait longer and longer before washing your hands. Over time, this gradual exposure and delayed response would help you learn to control your fear of germs in public places without washing your hands. It may seem weird, but this new way of confronting your fears directly will lead to fewer and less intense fears or obsessions about germs. Your brain learns that nothing bad happens when you stop performing compulsive rituals. You will probably feel very upset when you first touched the doorknob  maybe even feel a little panicked. But the body has a wonderful capacity for something called habituation, and anxiety will eventually lessen without doing anything but letting time pass. It’s something like jumping into a pool of cold water. When you jump in, the water may feel very cold. But after a while, your body gets used to the cold, thanks to habituation, and you feel fine. When your therapist helps you with exposures over a period of time, your anxiety shrinks until it is barely noticeable or even fades entirely. The therapist can then help you gain confidence and learn special skills to control the compulsions through a cognitive therapy.

Imaginal Exposure
For those who may be resistant to jumping right into real world situations, imaginal exposure sometimes referred to as visualization, can be a helpful way to alleviate enough anxiety to take the courage to move and  willingly to get exposure under ERP. With visualization, your assign therapist helps you to create a hypothetical but most closely related fear scenario that can elicits the anxiety someone might experience in a routine situation. person who fears walking down a hallway in a way that diverts from their “perfect” pattern, the therapist may have them picture themselves walking in that divergent manner for several minutes every day and record their level of anxiety. As they habituates to the discomfort, with decreased anxiety over time, they are gradually desensitized to the feared situation, making them more willing to move the process to real life, and engage in the next step of ERP.

Habit Reversal Training
This intervention includes awareness training, introduction of a competing response, social support, positive reinforcement, and often relaxation techniques. Awareness training may be practicing the habit or tic in front of a mirror, focusing on the sensations of the body and specific muscles before and while engaging in the behavior, and identifying and recording when the habit or tic occurs. These techniques increase awareness of how and when the urges develop, making it more likely that an individual will be able to intervene and make a change. That is where the competing response comes in, with the individual and therapist working together to find something similar to the movement or tic that is not noticeable to others. Someone with a vocal tic who learns awareness of the developing urge may practice tensing the muscles around their cheeks and mouth to ride out the urge and prevent the tic. Or someone with a compulsion to touch things symmetrically may be directed to tense the opposite arm, holding it tightly against their body, preventing them from completing the ritual. This method of treatment takes time, diligent practice, and patience, as well as integrating relaxation skills prior to beginning. Also extremely critical to success is the support and positive reinforcement of family

Cognitive Therapy
When applied to treating OCD, cognitive therapy helps you understand that the brain is sending error messages. Your therapist will help you learn to recognize these messages and respond to them in new ways to help you control your obsessions and compulsions. Cognitive therapy focuses on the meanings we attach to certain experiences that we misinterpret. For example, if a friend passes you without acknowledgment, you might interpret her action incorrectly and think “Maya doesn’t like me because she did not say hello.” And you might believe your thought is very important or meaningful. Cognitive therapy helps you stand back from these thoughts, look at the evidence closely, and tell yourself something more realistic or accurate, in this case it might be, “Something is on Maya mind, but I don’t know what it is”

Cognitive therapy for OCD focuses on the experience of negative thoughts. While most people easily dismiss such thoughts for example “That’s a silly thing to think” some people have certain beliefs that thoughts are always important. So instead of being able to just forget about these negative thoughts, their beliefs cause them to react differently and might make them think “I’m a bad person for having such a thought!” Research shows that believing that negative thoughts are important and attempting not to have “bad” thoughts actually produces the opposite effect.

What is Therapy or Psychotherapy is a way to help people with a broad variety of mental illnesses and emotional difficulties. Psychotherapy can help eliminate or control troubling symptoms so a person can function better and can increase emotional well-being and psychological healing. Also known as talk therapy, psychotherapy aim to help a person understand their feelings and equip them to face new challenges, both in the present and the future. In psychotherapy, psychologists apply scientifically validated procedures to help people develop healthier, more effective habits. There are several approaches to psychotherapy—including cognitive-behavioural, interpersonal, and other kinds of talk therapy—that help individuals work through their problems. Psychotherapy is a collaborative treatment based on the relationship between an individual and a psychologist. Grounded in dialogue, it provides a supportive environment that allows you to talk openly with someone who’s objective, neutral, and non-judgmental. You and your psychologist will work together to identify and change the thought and behaviour patterns that are keeping you from feeling your best.

Research shows that most people who receive psychotherapy experience symptom relief and are better able to function in their lives. About 75 percent of people who enter psychotherapy show benefit from it. Psychotherapy has been shown to improve emotions and behaviours and to be linked with positive changes in the brain and body. The benefits also include fewer sick days, less disability, fewer medical problems, increased work satisfaction and quality of life. With the use of brain imaging techniques researchers have been able to see changes in the brain after a person has undergone psychotherapy. Numerous studies have identified brain changes in people with mental illness as a result of undergoing psychotherapy. To help get the most out of psychotherapy, approach the therapy as a collaborative effort, be open and honest, and follow you’re agreed upon plan for treatment. Follow through with any assignments between sessions, such as writing in a journal or practicing what you’ve talked about. There are many approaches to psychotherapy. Some forms last for only a few sessions, while others may continue for months or years, depending on the person’s needs. Individual sessions usually last for around 45–90 minutes and follow a structured process.

Successful treatment is the result of three factors working together:

● Evidence-based treatment that is appropriate for your problem

● The psychologist’s clinical expertise

● Your characteristics, values, culture, and preferences

When people begin psychotherapy, they often feel that their distress is never going to end. Psychotherapy helps people understand that they can do lot of thing to improve their situation. That leads to changes that enhance healthy behaviour, whether it’s improving relationships, expressing emotions better, doing better at work or school, or thinking more positively or enhancing better mood and quality of life.