Obsessive-compulsive disorder (OCD) is a chronic anxiety disorder with an estimated lifetime prevalence in adults of 2–3 %. Our aim is to provide an overview of the development of effective psychological treatments for OCD, together with a systematic literature review of the latest research in the field. An extensive literature search was performed to identify relevant articles in several databases including MEDLINE, PUBMED and PsycINFO, using the following keywords: obsessive–compulsive disorder, cognitive-behavioural therapy, exposure, response prevention, cognitive therapy. Controlled trials have demonstrated that cognitive- behavioral therapy (CBT) is an effective treatment for OCD. CBT is at least as effective as medication and shows good benefits at follow up. Nevertheless, more studies are still needed, mainly focusing on long-term follow-up, group-treatment and the combined use of CBT with SSRIs. A prefrontal cortico-striato-thalamic brain system is involved in the mediation of OCD symptoms. Recent research has demonstrated that CBT for OCD can systematically modify cerebral metabolic activity in this cortico- subcortical circuit in a manner which is significantly related to clinical outcome.
Rarely has knowledge within cognitive psychology influenced the development and practice of cognitive behavior therapy. This article explores the integration of the contributions of the cognitive psychology areas of implicit learning, tacit knowledge structures, and encoding processes with producing or retarding change in cognitive behavior therapy. Differences are discussed between understanding something and knowing something. Implications for the practice of cognitive therapy, indeed all psychotherapy are discussed. A clinical example is provided.