Treating a Case of Disgust-Based Contamination Obsessive–Compulsive Disorder Using a Functional Approach to Exposure and Response Prevention: A Case Study

Abstract

Research has shown that disgust-based contamination obsessive–compulsive disorder (OCD) is often challenging to treat due to neurological and behavioral differences that can inhibit short-term habituation. This article presents a case study of using a novel functional approach to exposure and response prevention for disgust-based OCD focused on facilitating practice in avoided situations, incorporating concepts from acceptance and commitment therapy as well as emerging literature on using judicious safety behaviors to enable repeated practice. This case involves a 39-year-old male patient with disgust-based contamination OCD treated using this approach. Following a short course of psychotherapy combined with self-directed practice, the patient’s measured level of OCD severity (Yale–Brown Obsessive Compulsive Scale) was reduced by 56% over a 5-month period, with the patient meeting remission at posttreatment.