Clinician-reported challenges associated with delivery of exposure with response prevention for patients with obsessive-compulsive disorder

Exposure with response prevention (E/RP) within cognitive behavior therapy (CBT) is recognized as a critical therapeutic element that drives clinical improvement in the behavioral treatment of obsessive-compulsive disorder (OCD). However, many clinicians encounter a number of barriers when implementing E/RP for patients with OCD, negatively impacting patient outcomes. To understand and better address these challenges, we conducted a survey with 228 clinicians to capture the experiences of mental health providers that use E/RP to treat patients with OCD, and identify challenges they may experience when implementing this form of evidence-based care. We found that the majority of clinicians sampled endorsed facing barriers in implementing E/RP for patients with OCD. Additionally, we found that specific OCD symptom domains were identified by clinicians as difficult to complete exposures for within and between treatment sessions. Ultimately, this investigation identifies some of the challenges faced by clinicians using E/RP to treat patients with OCD, and offers several future research directions to pave the way toward addressing these barriers and improving treatment outcomes.