Efficacy of Cognitive-Behavioral Therapy

A number of studies have demonstrated that CBT is more effective than placebo and other psychotherapies for the treatment of OCD, is comparable to serotonergic medications,13,14,15,16,17 and may even be more effective than medication in some cases.18,19 A recent meta-analysis showed that CBT outperformed controls in all 16 studies used in the meta-analysis.20 However, many patients remain symptomatic after treatment, suggesting the need for continued research on improving efficacy of treatments.21

Although it is difficult to separate the effects of behavior therapy and cognitive therapy given that they contain similar components, exposure and response prevention (ERP) appear to be critical elements within CBT, with 55-75% of patients reporting sizable improvement and maintenance of gains following treatment. Given the vast number of studies demonstrating the efficacy of ERP,22,23 it continues to be the first-line CBT treatment for individuals with OCD.

However, studies supporting the efficacy of cognitive therapy have grown over the years24,25,26 and suggest that cognitive treatments are not only effective in improving symptoms and reducing emotional distress, but may also be effective in improving treatment adherence and reducing treatment drop-out.17  Although some studies shows that ERP outpaces cognitive treatments,17,27 others show that cognitive strategies may be equivalent in efficacy to behavioral strategies.28,20,29


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Lata K. McGinn, PhD, is an associate professor of psychology at the Ferkauf Graduate School of Psychology, Yeshiva University, Albert Einstein College of Medicine, in The Bronx, New York.

References

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