Inference Based Cognitive Behavior Therapy (I-CBT)?

[Dadof2kids3cats]

Hello, Our daughter L was transferred into a residential treatment program for mood and anxiety disorders on Thursday for what is intended to be a 30-45 day stay. It does not sound as if she will be getting a lot of ERP there, but at least she will be cut off from the opportunity to carry out some of her compulsions (e.g. going to the ER, checking her blood pressure repeatedly) and will be kept busier than she would be at home; they will also be able to monitor how she responds to her most recent medication switch (from Lexapro to Prozac.)

We expect that she will need further treatment when she leaves this program, and I am continuing to look into some of her possible treatment options. Do any of you have experience with or know something about “Inference-based Cognitive Behavior Therapy” (I-CBT)? I just became aware of it today. Apparently it is a less-stressful alternative to ERP, with some published scientific research supporting its effectiveness and several hundred therapists listed as offering it worldwide, including several in our immediate area. It also sounds like it might be a good fit for our daughter since it is more thought-oriented and less emotionally demanding than ERP, and she is a very clear thinker when not totally overwhelmed by her OCD. But I would hope to hear from people who have tried it, or at least are more familiar with it, before suggesting it as an option to L. Thanks for any responses. Wishing you all well.

[deValentin]

With ERP, you learn to tolerate the discomfort brought on by exposing yourself to triggers and not engaging in compulsions. You're relying mainly on habituation to free yourself from OCD.

On the other hand, I-CBT considers OCD more like a belief disorder. Like you said, it works more on a cognitive level. Far-fetched possibilities of harm are considered irrelevant, and you learn to rely on evidence through your senses and common sense to decide the best course of action. In other words, you learn to distinguish between imagined possibilities and real probabilities. If you confuse the two, you start on a path where turning back becomes increasingly difficult.

From my experience, I-CBT is helpful because it helps you redirect your focus from speculations to your present reality. What's important is what I can do so that my present actions would still make sense in my eyes after my OCD spike is over and the dust has settled. In the end, habituation to an OCD-free life, like with ERP, still plays a role in your recovery. I-CBT is not exempt of difficulties.

Mike Parker explains I-CBT in a very clear and accessible manner in his videos in OCD Space on YouTube .