This case report is about a 31-year-old married female with a variety of obsessions, primarily focusing on harming obsessions. Because of anxiety, numerous washing rituals have taken place as well as the avoidance of situations. This client was diagnosed with Obsessive-Compulsive Disorder (OCD) and was seen for 25 sessions of individual cognitive therapy. The aim of this study therefore was to illustrate the assessment, case conceptualization, and course of treatment in a severe obsessive-compulsive client, using cognitive therapy. Several specific cognitive interventions, which address the estimations of catastrophes and the perceptions of personal responsibility, are presented and illustrated. At posttreatment and at follow-up, a clinically significant change for improvement was demonstrated for the obsessive-compulsive symptoms.
Beck, A. T., Rush, A. J., Shaw, B. F., & Emery, G. (1979). Cognitive therapy of depression.New York: Guilford.
2.
Beck, A. T., Ward, C. H., Mendelson, M., Mock, J. E., & Erbaugh, J. K. (1961). An inventory for measuring depression. Archives of General Psychiatry, 17, 561-571.
3.
Carr, A. T. (1974). Compulsive neuroses: A review of the literature. Psychological Bulletin, 81, 311-318.
4.
Clark, A. M. (1989). Anxiety states: Panic and generalized anxiety. In K. Hawton, P. M. Salkovskis, J. Kirk, & D. M. Clark (Eds.), Cognitive behaviour therapy for psychiatric problems: A practical guide (pp. 52-96). Oxford, UK: Oxford University Press.
5.
Emmelkamp, P. M. G., & Aardema, A. (1999). Metacognition, specific obsessive-compulsive beliefs and obsessive-compulsive behaviour. Clinical Psychology and Psychotherapy, 6, 139-145.
6.
Emmelkamp, P. M. G., & Beens, H. (1991). Cognitive therapy with obsessive-compulsive patients: A comparative evaluation. Behaviour Research and Therapy, 29, 293-300.
7.
Emmelkamp, P. M. G., Kraaijkamp, H. J. M., & Van den Hout, M. A. (1999). Assessment of obsessive compulsive disorder. Behavior Modification, 23, 269-279.
8.
Emmelkamp, P. M. G., Visser, S., & Hoekstra, R. (1988). Cognitive therapy vs. exposure in the treatment of obsessive-compulsives. Cognitive Therapy and Research, 12, 103-114.
9.
Freeston, M.H., Ladouceur, R., Gagnon, F., & Thibodeau, N. (1991).Cognitive intrusions in a non-clinical population: I. Response style, subjective experience and appraisal. Behaviour Research and Therapy, 29, 285-297.
10.
Freeston, M. H., Ladouceur, R., Gagnon, F., Thibodeau, N., Rhéaume, J., Letarte, H., et al. (1997). Cognitive-behavioral treatment of obsessive thoughts: A controlled study. Journal of Consulting and Clinical Psychology, 65, 405-413.
11.
Freeston, M. H., Rhéaume, J., & Ladouceur, R. (1996). Correcting faulty appraisals of obsessional thoughts. Behaviour Research and Therapy, 34, 433-446.
12.
Goodman, W. K., Price, L. H., Rasmussen, S. A., Mazure, C., Fleischmann, R., Hill, C. L., et al. (1989). The Yale-Brown Obsessive-Compulsive Scale: I. Development, use, and reliability. Archives of General Psychiatry, 46, 1006-1011.
13.
Jacobson, N. S., & Truax, P. (1991). Clinical significance: A statistical approach to defining meaningful change in psychotherapy research. Journal of Consulting and Clinical Psychology, 59, 12-19.
14.
Luteijn, F., & Bouman, T.K. (1988). De valideteit van Beck’s Depression Inventory (The validity of Beck’s Depression Inventory). Nederlands Tijdschrift voor de psychologie, 43, 340-343.
15.
McFall, M. E., & Wollersheim, J. P. (1979). Obsessive-compulsive neurosis: A cognitive-behavioral formulation and approach to treatment. Cognitive Therapy and Research, 3, 333-348.
16.
Purdon, C. (1999). Thought suppression and psychopathology. Behaviour Research and Therapy, 37, 1029-1054.
17.
Rachman, S. J., & De Silva, P. (1978). Abnormal and normal obsessions. Behaviour Research and Therapy, 16, 233-248.
18.
Salkovskis, P. M. (1985). Obsessional-compulsive problems: A cognitive-behavioural analysis. Behaviour Research and Therapy, 23, 571-583.
19.
Salkovskis, P. M., & Harrison, J. (1984). Abnormal and normal obsessions—A replication. Behaviour Research and Therapy, 22, 549-552.
20.
Sanavio, E. (1988). Obsessions and compulsions: The Padua Inventory. Behaviour Research and Therapy, 26, 167-177.
21.
Van Oppen, P., & Arntz, A. (1994). Cognitive therapy for obsessive compulsive disorder. Behaviour Research and Therapy, 32, 79-87.
22.
Van Oppen, P.,de Haan, E.,Van Balkom, A. J. L. M., Spinhoven, P.,Hoogduin, K., & Van Dyck, R. (1995). Cognitive therapy and exposure in vivo in the treatment of obsessive compulsive disorder. Behaviour Research and Therapy, 33, 379-390.
23.
Van Oppen, P., Emmelkamp, P. M. G., Van Balkom, A. J. L. M., & Van Dyck, R. (1995). The sensitivity to change of measures for obsessive-compulsive disorder. Journal of Anxiety Disorders, 9, 241-248.
24.
Van Oppen, P., Hoekstra, R. J., & Emmelkamp, P. M. G. (1995). The structure of obsessive compulsive symptoms. Behaviour Research and Therapy, 33, 15-23.
25.
Watson, J. P., & Marks, I. M. (1971). Relevant and irrelevant fear in flooding—A crossover study of phobic patients. Behavior Therapy, 2, 275-293.
