Obsessive Compulsive Disorders (OCD) is one of the most common mental health conditions, affecting millions of people around the world. While there are many treatments for OCD, Cognitive Behaviour Therapy (CBT) is considered the most effective.
Cognitive Behaviour Therapy (CBT) is often an umbrella term for many distinct approaches. Two of the many Cognitive approaches are Exposure And Response Prevention (ERP) and Inference Based CBT (ICBT). In this article, we will discuss the differences between the two approaches
Understanding Inference Based Cognitive Behaviour Therapy (I-CBT)
I-CBT is a relatively new form of CBT, specifically designed to treat OCD. Unlike traditional CBT, which focuses on challenging intrusive thoughts to reduce OCD, I-CBT helps people to build awareness of how their mind works and focuses on identifying and correcting the faulty thought process that leads to obsessive or intrusive thinking.
According to I-CBT obsessions don’t come out of the blue, but they are a result of faulty or dysfunctional reasoning in which a person ends up confusing imagined possibilities with reality. This is known as inferential confusion. An I-CBT therapist works with clients to help them resolve their dysfunctional thought processes by helping them get in touch with reality through their five senses.
How Does I-CBT Help?
By identifying and correcting faulty reasoning patterns behind obsessions, I-CBT helps people differentiate between imagined possibilities and real-life evidence. This helps them create a balanced perspective on the obsession, leading to reduced anxiety.
I-CBT also helps people resolve their self-doubt (which often sustains their obsessions) by teaching them to trust their observations by relying on their 5 senses and making decisions based on this data. Reduced self-doubt and increased self-trust contribute to reduced anxiety and obsessions over time.
Understanding Exposure And Response Prevention (ERP)
ERP is another form of CBT specifically designed to work with OCD, but over the years, it has also been used to treat anxiety disorders and phobias. As the name suggests, ERP involves, gradually exposing people to feared objects, situations, or thoughts that trigger their obsessions and then preventing them from engaging in compulsive behaviours that they would typically use to reduce their anxiety.
How Does ERP Help?
With repeated exposure and response prevention, people learn that the consequences they fear, don’t actually happen in real life, leading to reduced anxiety over time. This realization also helps reduce obsessive thinking and urges to engage in compulsions. This process is known as habituation. Thus, through repeated, controlled exposure, ERP helps break the cycle of avoidance, which is a hallmark of conditions like OCD and anxiety. ERP is also accompanied by relaxation techniques that help people tolerate their anxiety
How Do They Differ?
ERP and I-CBT differ in significant ways. Let’s look at the table below to understand the differences:
| Aspect | I-CBT | ERP |
| Focus | Focuses on identifying and correcting underlying thought patterns causing obsessions | Focuses on reducing the cycle of obsession-compulsions through gradual exposure |
| Nature | This approach is more cognitive in nature | This approach relies more on practical exposure, hence, it is direct |
| Initial Discomfort | Might be low due to cognitive focus | Might be high due to direct exposure |
| Ideal For | People with high self-doubt, leading to OCD | People who are comfortable with gradual exposure |
Conclusion:
Both, I-CBT and ERP are effective approaches to treating OCD. The right choice, however, depends on an individual’s unique needs. While I-CBT can be beneficial for those who want to work on the self-doubt that leads to obsessions or who feel overwhelmed by exposure, ERP is beneficial for those who want to address their anxiety directly and are comfortable with gradual exposure.
If you are unsure about the right approach, consider consulting a mental-health professional, they can assess your conditions and needs and suggest an approach accordingly.
References:
- Aardema, F. (n.d.). What is I-CBT? Inference-Based Cognitive-Behavorial Therapy. Retrieved June 20, 2024, from https://icbt.online/what-is-icbt/
- ERP for OCD: How It Works, Examples & Effectiveness. (n.d.). ChoosingTherapy.Com. Retrieved June 20, 2024, from https://www.choosingtherapy.com/erp-for-ocd/
- Exposure Therapy for OCD: Understanding the Rationale is Key to Success. (n.d.). Verywell Mind. Retrieved June 20, 2024, from https://www.verywellmind.com/exposure-therapy-for-ocd-2510616
- Inference-Based CBT (I-CBT): How it Works, Examples, & Effectiveness. (n.d.). ChoosingTherapy.Com. Retrieved June 20, 2024, from https://www.choosingtherapy.com/icbt/
