half day workshop

INNOVATIONS IN THE TREATMENT OF REPUGNANT OBSESSIONS
Christine Purdon, Dept. of Psychology, University of Waterloo Canada and
David A. Clark, Psychology Department, University of New Brunswick Canada

Princess Hotel Room: Princess 1/2

Obsessive-compulsive disorder (OCD) is a heterogeneous condition that is difficult to treat, with success rates of approximately 50% when considering treatment refusal, drop-out and non-response rates. It may be that treatment efficacy could be improved by more targeted interventions that focus on specific obsessional symptoms. Recently, researchers have begun to advocate for the development of treatment strategies that are tailored to specific OCD sub-types (e.g., Taylor, in press). One well-acknowledged sub-type of OCD is repugnant obsessions with overt and covert checking rituals (e.g., Abramowitz et al., 2003). Repugnant obsessions (that is, obsessions with a sexual, religious, or harm/aggression theme) can be very difficult to treat because the feared consequences are perceived as so catastrophic that sufferers find it hard to accept a less cautious approach to them. Repugnant obsessions are especially shameful and embarrassing to discuss, and sufferers may conceal symptoms. Misapprehensions about thoughts and thought processes may play a more important role in the persistence of repugnant obsessions than in other types of obsessions. Finally, repugnant obsessions tend to be directly connected to individuals’ moral systems and personal values, which can complicate attempts to identify erroneous or irrational interpretations of the thought’s meaning. This workshop focuses on cognitive-behaviour therapy for overcoming repugnant obsessions, including strategies for: conducting a comprehensive assessment of obsessions and rituals, engaging clients in treatment, developing appropriate guidelines for behaving consistently with moral guidelines while giving up compulsions, and identifying and challenging erroneous appraisal. Relevant empirical research on thoughts and thought processes will be reviewed and the workshop will present ideas for exposure exercises and behavioural experiments.

David A. Clark, Ph.D., is Professor in the Department of Psychology, University of New Brunswick, Canada and a Founding Fellow of the Academy of Cognitive Therapy.  He maintains a private practice that specializes in cognitive behavior therapy for OCD.  He has authored several books on OCD and depression, and maintains an active funded research program on mental control, intrusions and depression vulnerability.  Christine Purdon, Ph.D., is an Associate Professor in the Department of Psychology at the University of Waterloo. She has received several early career awards for her research on OCD and has co-authored a self-help book on overcoming repugnant obsessions with Dr. Clark, and has co-edited a book on cognitive-behaviour therapy for OCD for professionals. Dr. Purdon has a private practice in which she assesses and treats anxiety and mood problems. She is a member of the Academy of Cognitive Therapy, the Obsessive-Compulsive Foundation, and the British Association of Behavioural and Cognitive Psychotherapies.

Key References:
Purdon, C. & Clark, D.A. (2005). Overcoming obsessive thoughts. Oakland, CA: New Harbinger Publications.
Antony, M. M., Purdon, C., & Summerfedlt, L.J.S. (Eds.) (in press). Cognitive-Behavioral Treatment of Obsessive Compulsive Disorder: Beyond the Basics. American Psychological Association Press. Purdon, C. (in press). Unacceptable obsessions and covert compulsions. Invited chapter for S. Taylor, J. Abramowitz and D. McKay (Eds.), Obsessive-Compulsive Disorder: Subtypes and Spectrum Conditions. Johns Hopkins University Press. 4.Purdon, C. (2004). Cognitive-behavioral treatment of repugnant obsessions. Journal of Clinical Psychology, 60, 1169-1180.