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OCD and Cognitive-Behavioral Therapy

online conference transcript

Our guest,Dr. Michael Gallo says a combination of Michael Gallo Cognitive-Behavioral Therapy (CBT) and medications is the best treatment for OCD (Obsessive-Compulsive Disorder). Cognitive Behavioral Therapy is a type of therapy where you identify and challenge your irrational thoughts and modify your behavior accordingly.

David Roberts is the HealthyPlace.com moderator.

The people in blue are audience members.


David: Good Evening. I'm David Roberts. I'm the moderator for tonight's conference. I want to welcome everyone to HealthyPlace.com.

Our topic tonight is "OCD and Cognitive-Behavioral Therapy". Our guest is Michael Gallo, PSY.D. Dr. Gallo has trained and served as a psychotherapist and researcher at several major OCD treatment centers, including Harvard Medical School/Massachusetts General Hospital and The Emory Clinic. Dr. Gallo practices in Atlanta, Georgia.

OCD and Cognitive-Behavioral Therapy. Treating OCD symptoms, irrational thoughts, compulsive behavior with CBT. Conference Transcript.Good evening Dr. Gallo and welcome to HealthyPlace.com. Thank you for being our guest tonight. So everyone knows, can you please define Cognitive-Behavioral Therapy (CBT)?

Dr. Gallo: Cognitive Behavioral Therapy is a very concrete, goal-oriented type of therapy. It focuses on helping people learn to identify, analyze and challenge irrational thoughts (i.e., the "cognitive" portion).

The behavioral portion of the therapy teaches people to change counter-productive behaviors which may be instigating or contributing to their problems.

David: Can you give us an example of CBT and how it would be used in relation to Obsessive-Compulsive Disorder?

Dr. Gallo: Well, that is a big question, but let me take a crack at it.

A person with OCD may feel compelled to engage in a less than rational, compulsive behavior. For example, excessive checking of door and window locks. CBT would help the person understand that by resisting the compulsive urge to check the locks, over-and-over again, they can eventually "wait out" their anxiety until the anxiety level dissipates over time. This is a technique known in CBT as Exposure and Response Prevention.

Cognitive therapy would work by helping the person rationally challenge the practical necessity for checking the locks multiple times.

David: What would you consider the optimum treatment for OCD (Obsessive-Compulsive Disorder)?

Dr. Gallo: Clinical research has clearly demonstrated that most people with moderate to severe OCD will respond best to a combination of OCD medications and Cognitive Behavioral Therapy. However, if one had to choose either OCD medications or CBT, I think the clear choice should be CBT. This is because CBT gives a person the tools to effectively manage their OCD for their entire life.

David: I realize that every person is different, but is there any general statistic you can give us, regarding the effectiveness of CBT alone. Can a person expect, let's say, a 50% relief of their OCD symptoms using CBT?

Dr. Gallo: In general, research has suggested that approximately 75-80% of people who diligently participate in CBT will achieve substantial relief from their OCD symptoms. I have personally had patients who, after suffering for years with severe OCD, have experienced as much as 80-90% reduction in symptoms and anxiety.

David: That's amazing. Is this a significant problem -- people with OCD become frustrated and give up before completing the therapy, getting all the tools they need to deal with the OCD symptoms?

Dr. Gallo: Yes, unfortunately one of the biggest problems encountered in CBT for OCD is resistance to full-fledged engagement in the therapy process. CBT is first and foremost...hard work! It requires persistence and high motivation on the part of the patient. In fact, ultimate success is highly correlated with the patient's level of motivation.

You see, engaging in CBT for OCD will require that a person "face their fears" (however, in a highly structured and supportive environment.

In CBT for OCD, a person can expect to "feel worse" before they ultimately feel better.

Cognitive Behavioral Therapy is akin to a highly effective, but bitter tasting medicine. However, if a person diligently participates in CBT for OCD it is virtually impossible for them NOT to experience at least some substantial improvement.

David: We have a lot of audience questions, Dr. Gallo. Here we go:

teddygirl: Do OCD and depression always go together?

Dr. Gallo: Not necessarily. However, having a severe problem with Obsessive-Compulsive Disorder often causes a person to become depressed in a "reactive", secondary way. It is only normal to feel depressed when you have such a problem with disturbing thoughts and compulsive rituals. Sometimes, however, OCD and depression are mutually exclusive and truly unrelated per se.

Hope20: Will that type of CBT ( Exposure and Response Prevention) also work for Trichotillomania sufferers?

Dr. Gallo: Trichotillmania is a special subtype of OCD that has many complex components. There is a specialized type of Behavioral Therapy called Habit Reversal which can be helpful in remediating problems with hair pulling. In short, this involves switching the hair pulling behavior to another more benign type habit (e.g., rubbing a touch-stone) which is incompatible with pulling one's hair.


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Last Updated: 29 March 2017
Reviewed by Harry Croft, MD

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