Strategies for Improving Long-Term Outcomes in Cognitive Behavioral Therapy for Obsessive-Compulsive Disorder: Insights From Learning Theory

• Describes an inhibitory learning approach to understanding relapse in CBT for OCD
• Provides suggestions for preventing relapse based on research on learning and memory
• Focuses on optimizing how imaginal and in vivo exposure can be implemented for OCD
• Includes recommendations for enhancing psychoeducational and cognitive aspects of CBT

Cognitive-behavioral therapy (CBT) for obsessive-compulsive disorder (OCD) is often highly effective, yet some patients experience relapses following a seemingly successful course of treatment. In this article we describe the components of CBT for OCD and then present a patient who relapses after making significant gains during a course of CBT. Likely explanations for the patient’s relapse, and methods for optimizing long-term treatment outcomes, are explored from the standpoint of research on learning and memory. These strategies mainly apply to the implementation of situational (in vivo) and imaginal exposure therapy, but also include suggestions for optimizing the psychoeducational and cognitive therapy components.