Abstract

This article reports on the integrated application of cognitive therapy, transactional analysis techniques, and the behavioral technique of response prevention using self-instructional training and behavioral substitution in a brief therapy approach. These methods were applied in the case of a young man who presented with compulsions to perform repetitive and ordering rituals with the belief that it would prevent his girlfriend from becoming pregnant. A 21-year-old white male who had performed 3 to 5 hours of rituals daily for several years was able to eliminate the majority of his compulsive behaviors and reduce his level of anxiety after eight clinical therapy sessions. Results were maintained at 6-month follow-up. The clear precipitating factors and the unusual maintaining variables for the disorder in the client are described. The author discusses the case in light of current theoretical, therapeutic, and biomedical understandings of the disorder.

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