Clinical social work and obsessive compulsive disorder. A single-subject investigation.

One adult with obsessive ruminations met a social worker for exposure sessions.

The client read, wrote, and listened to their obsession content until anxiety dropped.

The team tracked ruminations daily and checked again two years later.

Ruminations fell fast during treatment and stayed low for the full two years.

A single case showed exposure can give lasting relief from pure-O symptoms.

Early et al. (2012) later used the same exposure idea with an autistic teen.

Guertin et al. (2019) added response prevention for a preschooler with ID.

Stack et al. (2019) reviewed kids with both autism and OCD. They found CBT plus visuals and rewards works, but the core ingredient is still exposure.

Sasson et al. (2022) tested mindful emotion awareness on top of exposure for social anxiety. Results were mixed, showing the extra step may not help everyone.

You can borrow the simple format: have the client face the obsession content directly, stay until distress drops, and repeat. Track daily counts so you see change fast. The 1989 case and later replications show the same protocol helps across ages and diagnoses. Start with one client, collect data, and let the graph tell you if it works.