A 19-year-old man with OCD has predominantly contamination obsessions. He refuses to touch door handles and spends 4 hours daily washing his hands. The most evidence-based psychological treatment is:

• A Supportive psychotherapy with psychoeducation only
• B Psychodynamic therapy focusing on unconscious conflicts about cleanliness
• C Exposure and Response Prevention (ERP), a form of CBT ✓
• D EMDR (Eye Movement Desensitisation and Reprocessing)

Explanation

Exposure and Response Prevention (ERP) is the gold-standard evidence-based psychological treatment for OCD, recommended as first-line (alone for mild-moderate OCD, or combined with SSRIs for moderate-severe OCD). ERP involves systematic, graduated exposure to feared stimuli (e.g., touching a door handle) while refraining from the compulsive response (hand washing), thereby enabling habituation and extinction of anxiety. It is superior to supportive therapy, psychodynamic therapy (which has no evidence base for OCD), and EMDR (which is indicated for trauma, not OCD). Response rates with ERP approach 60–80%.

Reference: Kaplan & Sadock's Synopsis of Psychiatry, 11th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.