Greist J H
Dean Foundation for Health, Research and Education, Madison, Wis. 53717-1914.
J Clin Psychiatry. 1994 Oct;55 Suppl:60-8.
Exposure in vivo and ritual or response prevention are the essential elements of behavior therapy for obsessive compulsive disorder. Naturalistic behavior therapy helped a fortunate few before the effective elements of behavior therapy were identified and systematically applied. Homework exposure and response prevention are essential and therapist accompaniment is seldom necessary. Homework sessions are planned by patient and clinician and written records facilitate treatment modifications during homework sessions. About a quarter of patients refuse behavior therapy, but 90% of the remainder achieve worthwhile gains with exposure and response prevention. Limited availability of behavior therapy is a substantial public health problem.
体内暴露以及仪式行为阻止或反应阻止是强迫症行为疗法的基本要素。在行为疗法的有效要素被识别并系统应用之前，自然主义行为疗法帮助了少数幸运的患者。家庭作业式的暴露和反应阻止是必不可少的，且很少需要治疗师陪同。家庭作业环节由患者和临床医生共同规划，书面记录有助于在家庭作业环节中调整治疗方案。约四分之一的患者拒绝行为疗法，但其余患者中有90%通过暴露和反应阻止取得了显著疗效。行为疗法可及性有限是一个重大的公共卫生问题。
