You may be wondering, is dialectical behavioral therapy effective for managing my obsessive compulsive disorder (OCD)? This is a great question as there is a lot of conflicting information available online. In this blog, we will go over the evidence-based treatments for OCD and dive into how DBT can be an effective strategy in managing your symptoms.
Approaches to OCD
Exposure Response Prevention (ERP)
A form of cognitive behavioral therapy, ERP is widely considered the gold standard in treating OCD. It’s designed to confront, or expose, individuals to their fears that make up the intrusive thoughts of OCD. Through gradual exposure combined with learned responses that help manage the emotions that come up, this approach supports the reduction of compulsive behaviors. Check out my other blog on ERP if you want to learn more.
Cognitive Behavioral Therapy (CBT)
CBT without exposure techniques has also been shown to have positive outcomes in treatment. This approach focuses on recognizing unhelpful thought patterns and working towards replacing them with balanced or realistic beliefs. Like ERP, CBT is structured and goal-oriented, with the aim to reduce suffering and improve a person’s ability to break the cycle of negative thinking.
Why DBT?
If not the gold standard, you may be wondering how DBT fits in. Some people report finding CBT and ERP ineffective due to the persistent push for change, leaving them feeling invalidated or judged. Where DBT differs is the balanced approach to both change and acceptance with an emphasis on non-judgment. DBT’s four modules, or clusters of skills, are broken down below to demonstrate how DBT might be an effective OCD approach.
Emotion Regulation
OCD features anxiety, fear, and other intense emotions as a result of unwanted thoughts and compulsions. Emotion regulation assists with long-term management of emotions, seeking to prolong positive feelings and reduce the intensity of negative ones. This module includes techniques such as checking the facts and opposite action [hyperlink to one of our blogs?] which can help those with OCD combat their emotions and reduce the intensity of their OCD symptoms.
Distress Tolerance
These skills focus on a short-term but powerful reduction in negative emotions. Techniques such as TIP [hyperlink to one of our blogs?] can support management of OCD symptoms in assisting with resisting compulsions and tolerating anxiety during exposure.
Interpersonal Effectiveness
Though OCD mostly involves individual or internal struggles, this module can help with expressing your emotions and needs to others who may feel misunderstood or judged by others because of their symptoms.
Mindfulness
A core component of DBT is asking us to be aware and present for our thoughts and emotions. In treating OCD, this can be useful in helping to recognize the obsessive thoughts and respond to them in a more adaptive way.
Conclusion
Though DBT is not traditionally the go to treatment for OCD, research supports the four modules of DBT to be effective in improving cognitive functioning regardless of the diagnosis. While ERP continues to be the gold standard in treating OCD, DBT may be an effective alternative or addition to treatment. Don’t be afraid to ask your current or future clinician for more information to better understand what your treatment might look like.
About the Author
Eleanor Raker (she/her) MA., LPC is a Licensed Professional Counselor who specializes in Dialectical Behavioral Therapy. Eleanor works with teens (ages 14+) through adults who are seeking better balance in their lives and the tools to get them there. She believes the therapy process is unique to each person and strives to make meaningful connections to each client. Click here to learn more about Eleanor’s experience and therapeutic approach.
References
Gaudiano, B. A. (2008, February). Cognitive-Behavioural Therapies: Achievements and challenges. Evidence-based mental health. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3673298/
Vijayapriya, C., & Tamarana, R. (2023). Effectiveness of dialectical behavior therapy as a transdiagnostic treatment for improving cognitive functions: a systematic review. Research in Psychotherapy Psychopathology Process and Outcome, 26(2). https://doi.org/10.4081/ripppo.2023.662
Simpson, H., & Hezel, D. (2019). Exposure and response prevention for obsessive-compulsive disorder: A review and new directions. Indian Journal of Psychiatry, 61(7), 85. https://doi.org/10.4103/psychiatry.indianjpsychiatry_516_18