A few specific cognitive techniques used in the treatment of
OCD are as follows: Where patients overestimate personal
responsibility, the "pie technique" (25) has them give an initial
estimate ofthe percentage of responsibility that would be
attributable to them if a feared consequence were to occur.
The patient then generates a list ofthe parties (other than himself
or herself) who would also have some responsibility for
the feared consequence. The patient then draws a pie chart,
each slice of which represents one ofthe responsible parties
identified. Next, the patient labels all parties' slices according
to their percenage of responsibility and labels his or her own
slice last. By the exercise's end, it is generally clear to patients
that most of the responsibility for the feared event would not
be their own. For patients with difficulty discriminating
between unwanted obsessional thoughts and actions, the cognitive
continuum technique has them rate how immoral they
perceive themselves to be for having the intrusive obsessional
412 Can J Psychiatry, Vol 51, No 7, June 2006
The Psychological Treatment of Obsessive-Compulsive Disorder
thoughts. Next, patients rate the morality level of other individuals
who have committed acts of varying degrees of immorality
(for example, a serial rapist or abusive parents). Then,
patients again rate themselves and reevaluate how immoral
they are for simply experiencing intrusive thoughts.
A few specific cognitive techniques used in the treatment ofOCD are as follows: Where patients overestimate personalresponsibility, the "pie technique" (25) has them give an initialestimate ofthe percentage of responsibility that would beattributable to them if a feared consequence were to occur.The patient then generates a list ofthe parties (other than himselfor herself) who would also have some responsibility forthe feared consequence. The patient then draws a pie chart,each slice of which represents one ofthe responsible partiesidentified. Next, the patient labels all parties' slices accordingto their percenage of responsibility and labels his or her ownslice last. By the exercise's end, it is generally clear to patientsthat most of the responsibility for the feared event would notbe their own. For patients with difficulty discriminatingbetween unwanted obsessional thoughts and actions, the cognitivecontinuum technique has them rate how immoral theyperceive themselves to be for having the intrusive obsessional412 Can J Psychiatry, Vol 51, No 7, June 2006The Psychological Treatment of Obsessive-Compulsive Disorderthoughts. Next, patients rate the morality level of other individualswho have committed acts of varying degrees of immorality(for example, a serial rapist or abusive parents). Then,patients again rate themselves and reevaluate how immoralthey are for simply experiencing intrusive thoughts.
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