Inference-based Cognitive Behavioral Therapy (I-CBT)
Inference-Based Cognitive-Behavior Therapy (I-CBT) is an evidence-based treatment for Obsessive-Compulsive Disorder (OCD) that focuses on the idea that obsessions stem from abnormal doubts about what "could be" or "might be." Unlike traditional Cognitive-Behavioral Therapy (CBT) for OCD, I-CBT places emphasis on the reasoning narrative that precedes obsessions.
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I-CBT looks at the entire underlying structure (ICEBERG) of obsessional doubts, addressing reasoning and fears related to one's identity. ​I-CBT offers an alternative to ERP, acknowledging that not everyone can tolerate the distress caused by it, and it may not be suitable for everyone. I-CBT is a specialized cognitive-behavioral therapy for OCD that delves into the reasoning behind obsessions, addressing inferential confusion, vulnerabilities, and fears related to identity to bring about natural resolution of obsessional doubts.
1
Dysfunctional Reasoning Narrative
Obsessions are seen as the result of a dysfunctional reasoning narrative characterized by distrust of the senses and an over-reliance on imagination.
2
Persistent Obsessional Doubts:
Obsessional doubts can persist without resolution through compulsions because they arise from reasoning rather than random intrusive thoughts.
3
Focus on Inferences & Doubts
I-CBT distinguishes itself by addressing the initial obsessions and how they arise due to reasoning, in contrast to standard CBT that focuses on consequences, appraisals, anxiety, and compulsions.
4
Resolution of Obsessional Doubts
The goal of I-CBT is to bring resolution to obsessional doubts by teaching clients that these doubts don't arise in the same way as normal doubts.
5
Trusting Inner and Outer Senses
Throughout treatment, clients are encouraged to trust their inner and outer senses, minimizing room for obsessional doubts.
6
Inferential Confusion & Vulnerability
Obsessional doubts arise due to an "inferential confusion" where abstract possibilities are treated as actual probabilities, leading to a blurred line between reality and possibility during reasoning. Those with OCD are more vulnerable to inferential confusion due to a specific vulnerable self-theme, often related to fears about their identity.
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Behavioral Exercises
I-CBT does not include deliberate or prolonged exposure and response prevention (ERP) techniques. Instead, it takes a more cognitive approach, focusing on resolving obsessional doubts naturally. I-CBT is specifically designed for OCD and targets unique cognitive processes not directly addressed in other treatments.
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