A client with OCD is undergoing cognitive-behavioral therapy (CBT) The client asks the nurse, "How does exposure and response prevention work in treating OCD?" Which response by the nurse accurately explains this aspect of CBT?

Choice A rationale:

"Exposure and response prevention involves avoiding the triggers that lead to obsessions and compulsions." This statement is incorrect. Exposure and response prevention (ERP) in cognitive-behavioral therapy (CBT) for OCD involves facing the situations or triggers that lead to anxiety and obsessions. Instead of avoiding these triggers, individuals purposefully confront them to gradually reduce their anxiety response and break the cycle of performing compulsions in response to obsessions.

Choice B rationale:

"During exposure and response prevention, you'll engage in the compulsive behaviors to reduce anxiety gradually." This statement is also incorrect. ERP focuses on gradually reducing and eventually eliminating compulsive behaviors, not engaging in them. The goal is to help individuals learn that their anxiety naturally decreases over time when they refrain from performing the compulsions, ultimately breaking the connection between obsessions and anxiety-driven behaviors.

Choice C rationale:

"Exposure and response prevention helps you face the situations that trigger anxiety while preventing the compulsive behaviors." This statement accurately explains how exposure and response prevention works in treating OCD. During ERP, individuals purposefully confront situations that trigger their obsessions while refraining from engaging in compulsive behaviors. By doing so, they learn that their anxiety decreases without the need for compulsions, helping to weaken the link between obsessions and anxiety.

Choice D rationale:

"In exposure and response prevention, we eliminate all exposure to the situations that cause distress and anxiety." This statement is incorrect. ERP involves controlled exposure to distressing situations or triggers, not complete avoidance. The goal is to help individuals build tolerance to the anxiety triggered by these situations while resisting the urge to perform compulsions.

Choice A rationale:

Cognitive-behavioral therapy (CBT) often involves exposing individuals to feared stimuli or situations in a controlled and gradual manner, a technique known as exposure therapy. This exposure helps individuals confront their anxieties and gradually reduce their distress over time. Exposure therapy is a cornerstone of CBT for anxiety disorders, including OCD.

Choice C rationale:

Exposure and response prevention (ERP) is a critical component of CBT for OCD. This technique involves exposing the individual to anxiety-provoking situations or thoughts (exposure) while preventing the usual compulsive responses (response prevention). Through repeated exposures without engaging in compulsions, the individual learns that their anxiety naturally decreases over time, leading to habituation to the anxiety-provoking stimuli.

Choice E rationale:

Cognitive therapy within CBT aims to challenge and modify cognitive distortions and unrealistic beliefs that underlie OCD. Individuals with OCD often have distorted thought patterns, such as catastrophic thinking or black-and-white reasoning. Cognitive therapy helps individuals recognize and reframe these distorted thoughts, leading to more adaptive and realistic thinking patterns.

Choice B rationale:

This choice is not accurate. CBT does not primarily focus on replacing distorted thoughts with unrealistic beliefs. Instead, it focuses on identifying and modifying irrational or negative thought patterns.

Choice D rationale:

While CBT does aim to enhance positive emotional outcomes, this choice is not entirely accurate in describing the main goal of CBT for OCD. The primary goal of CBT is to reduce the symptoms and distress associated with obsessions and compulsions by addressing the cognitive and behavioral factors that maintain the disorder.