Effectiveness of cognitive therapy

Thus far, not many studies have assessed the effectiveness of cognitive therapy in treating OCD. Emmelkamp et al. (1980) tried self-instructional training, in which patients were instructed to change negative self statements into positive ones, and found it to do more harm than good, since patients are already engaging in excessive self-talk. Next, Rational Emotive Therapy was compared to self-exposure and was found to be as effective in treating OCD and more effective in treating depression.

This was replicated in a further study (Emmelkamp & Beens, 1991). However, the combination of exposure and response prevention with cognitive therapy was no more successful than behavior therapy alone.

Lopatka and Rachman (1995) manipulated perceived responsibility in checkers and found that decreases in perceived responsibility resulted in decreased mental distress and urges to check. A trend in the opposite direction was found when perceived responsibility was increased, but this effect did not reach statistical significance. The authors raised the possibility that the patients' levels of perceived responsibility were already so high that a ceiling effect may have existed.

Cognitive and behavior therapies combined.

In studies that have compared cognitive therapy with behavior therapy, no differences in effective ness have been found and no studies have found that the combination of behavior therapy and cognitive therapy is superior to behavior therapy alone (Emmelkamp, 1993; James & Blackburn, 1995).

In a study that challenged negative automatic thoughts, Salkovskis and Warwick (1985) found that cognitive therapy could be helpful in getting a patient to resume behavior therapy after discontinuing treatment and in treating overvalued ideas. The authors argue for the integration of cognitive and behavioral techniques. Cognitive therapy may be useful in treating depression and overvalued ideas and thus indirectly increase the effectiveness of behavior therapy (James & Blackburn, 1995).