Quieting the OCD Brain: Metacognitive Strategies & Tactics

Presented by: Dr. Reid Wilson

Exposure and response prevention (ERP) remains the gold standard for treating OCD, yet it’s not always sufficient on its own. A major contributor to persistent symptoms is repetitive negative thinking (RNT), which is fueled and sustained by negative metacognitive beliefs. Rather than targeting the content of clients’ thoughts, therapists can focus on modifying this cognitive-attentional syndrome using metacognitive strategies. In this session, you’ll explore a client-centered model framed as a “serious game,” where clients learn first to challenge their perspective on intrusive thoughts, and then to apply practical, moment‑by‑moment tactics whenever OCD tries to take over.

Learning Objectives

1: Persuade a client to challenge the common dysfunctional metacognitions of OCD

2. Explain the three stages of dissociation used in this strategic treatment model

3. Describe the benefits of the “approach” emotions of courage, determination and desire when facing anxious uncertainty during exposure