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Optimising outcomes in the cognitive behavioural treatment of OCD

Roz Shafran

7 Mar 2023


OCD is a common, disabling mental health problem which impacts significantly on quality of life. OCD usually takes a chronic course with low rates of spontaneous remission. A recent  clinical significance analysis of manualised psychological interventions for obsessive-compulsive disorder found low recovery rates with only one-third of treated patients being considered to have recovered (Rigby et al., 2021). The same meta-analysis reported that individual cognitive therapy (CT) was the most effective intervention. This workshop will consider how to optimise outcomes by harnessing recent significant advances in the understanding and treatment of OCD including the development of methods to increase engagement and optimise the chance of recovery. These treatment techniques incorporate a range of patient focused, advanced behavioural experiments which must be conducted with both skill and compassion.

The event will be equivalent to 5.1/2hrs of CPD.


This interactive online session will describe the ‘appraisal’ based cognitive behavioural approach to OCD. It will describe how to conduct personalised formulations of both the common forms of OCD (compulsive checking and washing) as well as less typical forms and complex, multi-faced OCD with a view to optimising engagement and outcomes. Advances in the treatment of OCD in the following areas will be presented: understanding and treating ‘mental contamination’, new methods for addressing repeated checking, tackling pure obsessions where the feared consequence cannot obviously be confirmed (e.g., going to hell for blasphemous thoughts) and ‘not just right experiences’. Treating OCD in the context of the pandemic will also be addressed. Participants are encouraged to bring their own cases for discussion and trouble-shooting and to contact the presenter with these directly in advance to ensure that the workshop, like therapy, can be personalised to meet the needs of the participants as far as possible.

Learning Objectives

• To be able to conduct a personalised formulation for patients with OCD
• To balance fidelity to the protocol with flexibility in delivery to develop ways to engage and treat individual patients with different forms of OCD.
• To conduct behavioural experiments to test ‘untestable’ beliefs
• To be able to identify and treat ‘mental contamination’
• To be aware of the cognitive behavioural model of repeated checking and its implications for treatment
• To be able to address different forms of OCD with confidence including ‘not just right experiences’ and ‘pure obsessions’

Training Modalities

The workshop will be interactive and include both experiential and didactic teaching and videos. Participants are encouraged to bring and role-play their own cases.

Key References

Rachman, S. (1997). A cognitive theory of obsessions. Behaviour Research and Therapy, 35, 793-802

Rachman, S., Coughtrey, A., Shafran, R., & Radomsky, A. 2014). Oxford guide to the treatment of mental contamination. OUP Oxford.

Radomsky, A. S., et al., (2020). Cognitive therapy for compulsive checking in obsessive-compulsive disorder: A pilot trial. Psychiatry research, 286, 112850.

Rigby, J., Fisher, P., Cherry, G., Stuart, T., & Temple, J. (2021). A clinical significance analysis of manualised psychological interventions for obsessive-compulsive disorder. BJPsych Open, 7(S1), S285-S285.

Shafran, R., Coughtrey, A., & Whittal, M. (2020). Recognising and addressing the impact of COVID-19 on obsessive-compulsive disorder. The Lancet Psychiatry, 7(7), 570-572.

About the presenter

Roz Shafran is Director of Bespoke Mental Health and Professor of Translational Psychology at the UCL Great Ormond Street Institute of Child Health. Her clinical and research interests have focused on developing, evaluating and disseminating evidence-based psychological therapies across the age range. She has published over 250 research papers in areas such as OCD, Perfectionism, loneliness, and Eating Disorders and delivered numerous international workshops in these areas.

Who should attend

This event is suitable for clinicians delivering ‘high intensity’ cognitive behavioural therapy with some experience of OCD.

Low Intensity clinical contact hours survey - BABCP Low Intensity Special Interest Group

Please click below if you are interested in contributing to the survey.


The BACP Low Intensity SIG are interested in the impact of clinical contact hours on Low Intensity/Wellbeing Practitioner wellbeing. This questionnaire contains six multi-choice questions and a free text box for you to share your experiences. The answers to these questions will help the BABCP SIG plan how to meet CPD topics and other developments within the SIG.  The SIG hope to produce a write up of the answers to this questionnaire to be shared with SIG members and to be used in training.

View Survey

This FREE conference is for Psychological Wellbeing Practitioners working in Talking Therapies for Anxiety and Depression services and is brought to you by Bespoke Mental Health in collaboration with the NHS England Talking Therapies National PWP Leads Network

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