C12 – An Introduction to Cognitive-Behavioural Therapy for Obsessive–Compulsive Disorder, Hoarding Disorder, Body Dysmorphic Disorder, and the Body-Focused Repetitive Disorders

C12 – An Introduction to Cognitive-Behavioural Therapy for Obsessive–Compulsive Disorder, Hoarding Disorder, Body Dysmorphic Disorder, and the Body-Focused Repetitive Disorders

Saturday, Oct. 29
14:30 – 16:30 (2 hrs)
Meeting Room: Sheraton Hall C (Lower Concourse)
Peggy Richter*, MD, FRCPC; David Castle, MSc MD; Jamie Feusner, MD; Rahat Hossain, MD

CanMEDS Roles:

  1. Medical Expert
  2. Scholar
  3. Communicator

At the end of this session, participants will be able to: 1) Appreciate key differences in the application of cognitive-behavioural therapy (CBT) to obsessive–compulsive and related disorders (OCRDs); 2) Describe specific CBT techniques used with clients with specific OCRDs; and 3) Support clients in CBT for OCRDs using appropriate client manuals.

The obsessive–compulsive related disorders (OCRDs) are relatively common conditions (each affects 1% to 5% of the population), cause significant distress, and can be markedly impairing for those affected. Despite their prevalence, few practitioners are familiar with evidence-based treatment approaches to these conditions. Disorder-specific cognitive-behavioural therapy (CBT) has been developed for each of these conditions, using distinctive and differing approaches and techniques. This course is intended for attendees with basic proficiency in CBT as applied in mood and anxiety disorders. We will introduce the core concepts of CBT as applied to obsessive–compulsive disorder (OCD) and each of the OCRDs and will outline key techniques. For OCD, we will review exposure and response prevention, with a focus on optimizing this treatment approach and addressing common issues that arise. Manualized treatments have been developed for hoarding disorder, with an emphasis on addressing core symptom domains of difficulty discarding, excessive acquiring, and information-processing deficits. CBT for body dysmorphic disorder focuses on cognitive restructuring, exposure and prevention of rituals (such as excessive grooming, checking, and reassurance seeking), and perceptual retraining. The comprehensive behavioural (ComB) method has been shown to be effective for hair-pulling disorder and can be easily adapted to skin-picking disorder as well. This method focuses on identifying key triggers and individualizing treatment targets accordingly. We will conclude with an opportunity for attendees to discuss the application of these techniques to their own cases. Useful CBT manuals and online resources will be discussed.

References:

  1. Castle D, Beilharz F, Phillips KA, et al. Body dysmorphic disorder: a treatment synthesis and consensus on behalf of the International College of Obsessive–Compulsive Spectrum Disorders and the Obsessive Compulsive and Related Disorders Network of the European College of Neuropsychopharmacology. Int Clin Psychopharmacol 2021;36(2):61–75.
  2. Mathes BM, Van Kirk N, Elias JA. Review of psychotherapeutic approaches for OCD and related disorders. Curr Treat Options Psychiatry 2015;2:294–6.