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COGNITIVE-BEHAVIORAL THERAPY FOR OCD
DAVID A. CLARK
THE GUILFORD PRESS New York London
© 2004 The Guilford Press A Division of Guilford Publications, Inc. 72 Spring Street, New York, NY 10012 www.guilford.com All rights reserved Paperback edition 2007 Except as noted, no part of this book may be reproduced, translated, stored in a retrieval system, or transmitted, in any form or by any means, electronic, mechanical, photocopying, microfilming, recording, or otherwise, without written permission from the Publisher. Printed in the United States of America This book is printed on acid-free paper. Last digit is print number: 9 8 7 6 5 4 3 LIMITED PHOTOCOPY LICENSE The Publisher grants to individual purchasers of this book nonassignable permission to reproduce the appendices of this book. This license is limited to you, the individual purchaser, for use with your own clients and patients. It does not extend to additional clinicians or practice settings, nor does purchase by an institution constitute a site license. This license does not grant the right to reproduce these materials for resale, redistribution, or any other purposes (including but not limited to books, pamphlets, articles, video- or audiotapes, and handouts of slides for lectures or workshops). Permission to reproduce these materials for these and other purposes must be obtained in writing from the Permissions Department of Guilford Publications. Library of Congress Cataloging-in-Publication Data Clark, David A., 1954– Cognitive-behavioral therapy for OCD / David A. Clark. p. cm. Includes bibliographical references and index. ISBN-10: 1-57230-963-6 ISBN-13: 978-1-57230-963-0 (hardcover: alk. paper) ISBN-10: 1-59385-375-0 ISBN-13: 978-1-59385-375-4 (paperback) 1. Cognitive therapy. 2. Obsessive–compulsive disorder. I. Title. RC489.C63C57 2004 616.85′2270651—dc22 2003020283
To my parents, Albert and Ardith, for their support and encouragement
About the Author
About the Author
David A. Clark, PhD, is a professor in the Department of Psychology, University of New Brunswick, Canada. He received his PhD from the Institute of Psychiatry, University of London, England. Dr. Clark has published numerous articles on cognitive theory and therapy of depression and obsessive–compulsive disorders (OCD), and is a Founding Fellow of the Academy of Cognitive Therapy. He is coauthor, with Aaron T. Beck, of Scientific Foundations of Cognitive Theory and Therapy of Depression and coeditor, with Mark Reinecke, of Cognitive Therapy across the Lifespan: Evidence and Practice. Drs. Clark and Beck recently developed the Clark–Beck Obsessive–Compulsive Inventory to assess self-reported severity of obsessive and compulsive symptoms. Dr. Clark has received a number of research grants to study the cognitive basis of emotional disorders, the most recent being a Canadian federal grant to investigate intentional control of unwanted intrusive thoughts. He is also a founding member of the Obsessive Compulsive Cognitions Working Group, an international research group devoted to the study of the cognitive aspects of OCD, and the past Associate Editor of Cognitive Therapy and Research.
The cognitive-behavioral perspective is a relatively new development in the theory and treatment of obsessive–compulsive disorders (OCD). The possibility that a greater emphasis on cognitive factors might enhance a behavioral account of OCD can be traced back to Carr (1974), McFall and Wollersheim (1979), Rachman and Hodgson (1980), and Salkovskis (1985). Behavior therapy in the form of exposure and response prevention (ERP), which emerged in the 1960s and 1970s, proved to be a highly effective treatment for many forms of OCD. Behavioral research on obsessions and compulsions offered new insights into the pathogenesis of the disorder. Yet, by the early 1980s, behavioral research into...