The New Kid on The Block
For years we have known that ERP (exposure and response prevention) is the gold standard treatment for OCD. I have been using ERP with my clients for years, and many have been able to get their life back using this approach.
But the truth is, the research says that only 60% of clients will get better with ERP. So then what? Do those individuals just live with the suffering that OCD has caused them? Should they just give up? Accept that this is as good as it’s going to get?
Hell no. There has to be more. And luckily, there is.
For the past 9 months, I’ve been seeking ongoing training and consultation with hundreds of other OCD therapists across the country on a therapy called Inference Based CBT.
Is it new? Sort of, but not really.
What is Inference Based Therapy (ICBT)?
Inference Based Therapy has been around since the early 2000s. It has undergone many randomized controlled studies comparing it to ERP, and the data has shown to be just as effective as ERP.
This is great news. This means that we have more than one way to effectively treat OCD.
ICBT is a cognitive therapy for OCD. ICBT aims to resolve “inferential confusion.” Which is when someone confuses imagined possibility with reality.
ICBT works “upstream” by addressing the doubt (or what if?) that set the OCD into motion.
By working upstream, when you can resolve the doubt, then the anxiety and compulsions do not occur.
ICBT looks at what is behind the doubt. There is a reasoning process you use with obsessional doubts that you don’t use with normal doubts. You reason differently in OCD situations than every other area of your life. We teach you how to see the difference.
ICBT says that intrusive and obsessive thoughts do not occur by random, there is a story behind them. The story is absorbing and takes you behind your senses.
ICBT aims to help people return to trusting themselves and their senses.
What I love about ICBT
I’ve been using ICBT with the majority of my clients with OCD for the past 6 months. I still consider myself a beginner but many of my clients feel like this makes so much sense. It’s also common for some of my clients to feel confused. Because this is very different than what they were previously learning through an ERP approach.
This was my experience in learning ICBT too. It has (and still does) take a lot of work to see how this approach works.
I love how well rounded this model of therapy is. In ERP, there is no real in depth discussion about how a person came to become so consumed with their worries. And in ICBT, we really help people understand this and I have seen this be so validating to my clients to have a deeper understanding of themselves.
I love how interactive it is. We use games and exercises to apply the concepts so that clients can arrive at these conclusions on their own.
And mostly, I love having an additional treatment option for clients. Exposure will still be a treatment I use in my practice but when a client isn’t making progress or isn’t ready to try ERP, it’s nice to have other ways of helping them regain their life.
Questions about ICBT? Send me an email at jenny@stateofmindtherapy.com
Written by Jenny Matthews, LMFT, LADC
Jenny is a therapist that specializes in helping over-thinkers and worriers get relief from anxiety so they can be more productive + do what matters + be present with their loved ones.
