Justice-based treatment considerations for identity-related obsessive–compulsive disorder

The obsessive–compulsive disorder (OCD) field is undergoing an important and timely cultural shift in how identity-related symptom themes (e.g., obsessions about racism, sexual orientation, disability, poverty, etc.) are conceptualized and addressed using justice-based exposure and response preventi...

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Bibliographic Details
Published in:Clinical psychology (New York, N.Y.) N.Y.), 2024-10, Vol.31 (4), p.466-478
Main Authors: Pinciotti, Caitlin M., Wadsworth, Lauren P., Greenburg, Cailin, Rosenthal, Krishtine
Format: Article
Language:English
Subjects:
Exposure and Response Prevention Therapy
Human
Identity Formation
Justice
Obsessive Compulsive Disorder
Sexual Orientation
Social Identity
Socioeconomic Status
Treatment
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Summary:The obsessive–compulsive disorder (OCD) field is undergoing an important and timely cultural shift in how identity-related symptom themes (e.g., obsessions about racism, sexual orientation, disability, poverty, etc.) are conceptualized and addressed using justice-based exposure and response prevention (ERP). Justice-based treatment is defined as an “equitable, thorough, and compassionate lens through which to conceptualize and implement mental health treatment so that all impacted persons—client, provider, and society—are respected” (Pinciotti, Smith, Singh, et al., 2022, p. 154). This article extends this seminal work on justice-based ERP with OCD for sexual orientation and gender themes by detailing how to apply this updated approach to other identity-related symptom themes that implicate race/ethnicity, age, disability and diagnosis status, socioeconomic status, and body shape and size. Current accepted practices for and misuse of ERP with identity-related OCD are described, including the ways in which these practices are antithetical to ERP principles, reinforce harmful stereotypes, and further marginalize communities. A justice-based approach to identity-related OCD is then presented, including how a justice-based lens can inform conceptualization, and implementing exposures to psychoeducation, uncertainty, core fears, and neutral and positive stimuli, while still maintaining fidelity to the evidence-based strategies and theoretical model underpinning effective ERP treatment. (PsycInfo Database Record (c) 2024 APA, all rights reserved) (Source: journal abstract)
ISSN:0969-5893
1468-2850
DOI:10.1037/cps0000224