Candidate instructions

You are the psychiatry registrar. Priya, 31, has contamination OCD on sertraline 150 mg oral daily with partial benefit. She washes after any outdoor contact and her partner answers "are my hands clean?" many times daily. She is anxious about "making OCD worse" with exposure. In 10 minutes:^[13]

Explain ERP rationale in plain collaborative language.
Negotiate one concrete first exposure with a clear response-prevention rule.
Elicit predicted outcome (expectancy) and how you will review learning.
Address partner accommodation without shaming.
Set between-session homework and a brief risk/distress plan.
Avoid becoming a reassurance ritual yourself.

^[12] ^[13]

References5Show

[1]Foa EB, Liebowitz MR, Kozak MJ, et al. Randomized, placebo-controlled trial of exposure and ritual prevention, clomipramine, and their combination in the treatment of obsessive-compulsive disorder Am J Psychiatry, 2005.PMID 15625214
[3]Simpson HB, Foa EB, Liebowitz MR, et al. Cognitive-behavioral therapy vs risperidone for augmenting serotonin reuptake inhibitors in obsessive-compulsive disorder: a randomized clinical trial JAMA Psychiatry, 2013.PMID 24026523
[12]Craske MG, Treanor M, Conway CC, et al. Maximizing exposure therapy: an inhibitory learning approach Behav Res Ther, 2014.PMID 24864005
[13]Hezel DM, Simpson HB Exposure and response prevention for obsessive-compulsive disorder: A review and new directions Indian J Psychiatry, 2019.PMID 30745681
[14]Goodman WK, Price LH, Rasmussen SA, et al. The Yale-Brown Obsessive Compulsive Scale. I. Development, use, and reliability Arch Gen Psychiatry, 1989.PMID 2684084

Candidate instructions

Explain ERP rationale in plain collaborative language.

Negotiate one concrete first exposure with a clear response-prevention rule.

Elicit predicted outcome (expectancy) and how you will review learning.

Address partner accommodation without shaming.

Set between-session homework and a brief risk/distress plan.

Avoid becoming a reassurance ritual yourself.

References5Show

[1]Foa EB, Liebowitz MR, Kozak MJ, et al. Randomized, placebo-controlled trial of exposure and ritual prevention, clomipramine, and their combination in the treatment of obsessive-compulsive disorder Am J Psychiatry, 2005.PMID 15625214
[3]Simpson HB, Foa EB, Liebowitz MR, et al. Cognitive-behavioral therapy vs risperidone for augmenting serotonin reuptake inhibitors in obsessive-compulsive disorder: a randomized clinical trial JAMA Psychiatry, 2013.PMID 24026523
[12]Craske MG, Treanor M, Conway CC, et al. Maximizing exposure therapy: an inhibitory learning approach Behav Res Ther, 2014.PMID 24864005
[13]Hezel DM, Simpson HB Exposure and response prevention for obsessive-compulsive disorder: A review and new directions Indian J Psychiatry, 2019.PMID 30745681
[14]Goodman WK, Price LH, Rasmussen SA, et al. The Yale-Brown Obsessive Compulsive Scale. I. Development, use, and reliability Arch Gen Psychiatry, 1989.PMID 2684084