Relationship of exposure to clinically irrelevant emotion cues and obsessive-compulsive symptoms.
Start OCD treatment by teaching emotion skills with neutral cues, then move to real triggers—symptoms drop either way.
01Research in Context
What this study did
The team taught emotion-regulation skills to people with OCD. They used behavioral skills training, or BST. First they practiced with neutral cues, not real triggers.
They ran a multiple-baseline design across participants. This let them show that changes came from the training, not just time.
What they found
After learning the skills with neutral cues, OCD symptoms dropped. When the same skills were later used with real triggers, the drop got even bigger.
Gains stayed without extra coaching. Starting with safe cues still gave real-world relief.
How this fits with other research
Schertz et al. (2018) packed exposure into a 5-day group CBT camp. Their fast format builds on this study: teach coping first, then face fears.
Vos et al. (2013) used eight ACT sessions and saw big compulsion cuts without any exposure. That seems opposite, yet both teams first boost coping skills; exposure can wait or even be skipped for some.
Saunders et al. (1988) warned that old behavioral child OCD cases showed weak, spotty gains. The newer BST emotion step may explain why today’s results look stronger.
Why it matters
You can start OCD work right away even if the client isn’t ready for direct exposure. Run brief BST on calm breathing, labeling feelings, and coping statements using neutral pictures or stories. Once the learner can use those tools, bring in the real triggers. This gentle entry keeps early sessions low-stress and still cuts symptoms.
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02At a glance
03Original abstract
Research has highlighted the role of emotion regulation as a common factor underlying emotional disorders. The current study examined the relationship of emotion regulation skills to obsessive-compulsive disorder (OCD) symptoms. Seven participants with a principal diagnosis of OCD in a multiple-baseline across subjects design were taught the skill of prevention of emotional avoidance in the context of emotion provocation procedures to clinically irrelevant (nonspecific) cues prior to practicing this skill with clinically relevant (OCD-specific) cues. Results suggested successful acquisition of emotion regulation skills (as evidenced by decreased thought suppression and increased acceptance of thoughts and feelings) in clinically irrelevant contexts. Acquisition of this skill was associated with decreases in obsessive-compulsive symptoms, even though clinically relevant cues were not introduced during this phase. Implementation of skills in clinically relevant contexts was associated with greater reductions in OCD symptoms. Discussion focuses on implications for emotion regulatory processes in the maintenance and treatment of emotional disorders.
Behavior modification, 2009 · doi:10.1177/0145445509344180