I-CBT for OCD: How Inference Based Therapy Works and When It Helps

The strengths of this study include adherence to CONSORT guidelines for non-inferiority trials, a large sample size, inclusion/exclusion criteria aimed at maximizing generalizability, the use of psychometrically sound measures, and a 12-month follow-up period. First, as mentioned before, therapists had far more experience with CBT than I-CBT, potentially impacting our findings. The novelty of I-CBT inevitably results in a scarcity of experienced therapists. To address this, new therapists in I-CBT should treat a minimum of 2 patients under supervision before participating in trials. Additionally, future research should limit the number of therapists in each group to allow for more experience with new treatments. Second, therapist allegiance was not considered, potentially introducing a bias.

inference based cognitive behavioral therapy

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Bimonthly supervision by skilled supervisors was provided in both conditions during this study. CalmOCD is proud to be a safe, inclusive, and affirming space for all individuals, including our LGBTQIA+ community. Randomized controlled trials have shown that I-CBT is as effective as exposure-based therapy, with large treatment effects and high acceptability among participants. You come to recognize that obsessional doubts are not genuine uncertainties but false inferences disconnected from reality. Once the faulty reasoning is corrected, the doubt loses power—and with it, the anxiety and compulsions it once produced. Cognitive behavioral therapy (CBT) is a form of talking therapy that can be used to treat people with a wide range of mental health problems, including anxiety disorders (e.g., generalized anxiety, social anxiety) or depression.

How many sessions will I need?

If you want to understand why you experience particular obsessional doubts, and how OCD tricks you into feeling like you need to listen to your obsessional doubts, then I-CBT might be a good fit for you. Estimated mean Y-BOCS scores of the ITT sample from LMM correcting for pretreatment differences by treatment group at pretreatment (T0), posttreatment (T1) and 6 months’ (T2), and 12 months’ (T3) follow-up using standard deviation error bars. The research assessors were blinded to the treatment conditions; however, this was not always maintained until the final measurement. If blinding was unintentionally broken, participants were reassigned to a new blinded assessor, if feasible. In instances where this was not possible, assessors were not part of the research team, data analysis, or writing process to ensure impartiality. Therapists and participants were instructed not to disclose the treatment details to the assessors.

  • When a person suffers from psychological distress, how they interpret situations becomes skewed, which, in turn, has a negative impact on the actions they take.
  • I-CBT can be effective for people with only OCD and with OCD and comorbid conditions.
  • The first three steps analyze the process by which a person has developed irrational beliefs and may be recorded in a three-column table.
  • Fourth, the assessors were not blinded to the assessment time points, which might have influenced their assessments of improvements.

A Different Way to Understand OCD

The cognitive triangle is a tool used in CBT to demonstrate the interplay between thoughts, feelings, and behaviors. The treatment has been successfully adapted for use with children in Cognitive Behavioral Therapy case studies but there is a need for additional research in this population. Consequently, parents or guardians of children should be fully informed on the current state of research to be able to provide informed consent for I-CBT, including its limitations and potential benefits depending on the child’s condition and previous history. The Doubt Illusion is finally here — a concise, engaging guide to understanding obsessional doubt through the lens of ICBT. You are invited to explore our treatment resources with references,  manuals, treatment modules, therapy materials, and opportunities for further learning. The data that support the findings of this study are not publicly available due to ethical restrictions but are available from the corresponding author (N.W.) upon reasonable request.