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Recent advances in behavioral and biological treatments have raised
the hopes and expectations of patients and clinicians alike in
regard to obsessive-compulsive disorder-one of the most disabling,
crippling, and resistant conditions in psy chiatry. In addition to
their therapeutic efficacy, these new treatments have also opened
new conceptual perspectives, thus complementing the traditional
psychological theories of obsessive-compulsive disorder. Therefore,
it is timely for these various conceptual frameworks and the
treatment modalities they engender to be integrated and synthesized
in the pres ent volume. To this end, eminent scholars in their
respective areas were invited to contribute to this book, which we
hope will symbolize and-in some measure-actualize the spirit of
collaboration required if we are to fully comprehend the com plex
nature of this disorder as well as to address existing ther apeutic
challenges. In Chapter 1, Rachman sets the stage by providing an
overview of the conceptual and therapeutic issues of
obsessive-compulsive disorder. This is followed by an in depth
review of the behavioral interventions from which Foa vii viii
PREFACE and colleagues successfully distill the specific
therapeutic processes of exposure and response prevention. In the
third chapter, Sifneos deals with the psychodynamic factors under
lying obsessive-compulsive phenomena and details his in novative
technique of brief, anxiety-provoking psychotherapy aimed
specifically at the obsessional state."
Recent advances in behavioral and biological treatments have raised
the hopes and expectations of patients and clinicians alike in
regard to obsessive-compulsive disorder-one of the most disabling,
crippling, and resistant conditions in psy chiatry. In addition to
their therapeutic efficacy, these new treatments have also opened
new conceptual perspectives, thus complementing the traditional
psychological theories of obsessive-compulsive disorder. Therefore,
it is timely for these various conceptual frameworks and the
treatment modalities they engender to be integrated and synthesized
in the pres ent volume. To this end, eminent scholars in their
respective areas were invited to contribute to this book, which we
hope will symbolize and-in some measure-actualize the spirit of
collaboration required if we are to fully comprehend the com plex
nature of this disorder as well as to address existing ther apeutic
challenges. In Chapter 1, Rachman sets the stage by providing an
overview of the conceptual and therapeutic issues of
obsessive-compulsive disorder. This is followed by an in depth
review of the behavioral interventions from which Foa vii viii
PREFACE and colleagues successfully distill the specific
therapeutic processes of exposure and response prevention. In the
third chapter, Sifneos deals with the psychodynamic factors under
lying obsessive-compulsive phenomena and details his in novative
technique of brief, anxiety-provoking psychotherapy aimed
specifically at the obsessional state."
Contemporary behavior therapy encompasses diverse conceptual
positions, clinical and applied problems, and intervention
techniques. Behavior therapy has spread to several disciplines to
provide substantive concepts and procedures as well as
methodological tenets regarding how intervention techniques are to
be evaluated. The proliferation of behavior therapy research has
produced a plethora of texts. Typically texts review the history of
particular treatments and detail contemporary advances. The
historical underpinnings are often emphasized with the heavily
labored view that in order to understand where one is going, it is
important to understand where one has been. To be sure, historical
roots of behavior therapy are important to document. However, a
given history might have many different outcomes. Similarly, the
current status of par ticular areas is frequently reviewed.
Sometimes the number of reviews seems to approach or exceed the
number of sound studies that there are to be reviewed. A review of
current work is obviously essential but leaves open major questions
of where the work will all lead. A valuable addition to ex isting
reviews would be information that points in a prescriptive or
explicit way to areas that are likely to be important in future
work. The present book is unique in its approach and focus. Brief
reviews of contemporary advances are provided in diverse areas of
behavior therapy and serve as a point of departure to chart
emerging trends and future direc tions."
When behavior therapy was first applied to what would now be
labeled an anxiety disorder, a simplistic theoretical model guided
the treatment of a sim ple phobia. Time and research have shown
that the techniques of behavior ther apy have been more successful
than its models have been explanatory. Yet progress has been
substantial in both realms, as the following volume makes patently
clear. In 1980 an inventory of this progress was catalogued at an
NIMH-sponsored workshop. What both that workshop and this volume
clearly show is that the behav ior therapy researcher need no
longer suffer the epithet "overly simplistic." One of the major
strengths of this volume is its elucidation of the complexities
that now attend the study of the anxiety disorders, particularly
from a behav ioral point of view. The researcher at times appears
almost to be buried in a landslide of complexities regarding this
topic. The concept of anxiety itself has undergone a
differentiation to a level of complexity that poses problems for
both the conceptualization and the treat ment of anxiety disorders.
In virtually one voice, the several authors of this volume argue
the multidimensional nature of anxiety. The "lump" view of anx iety
has given way to the three-channel view of anxiety. An
investigator's future research career could well be secured just by
spending time puzzling out the significance of the low
intercorrelations among the channels."
During the past decade, research and practice in the field of
behavior modification have experienced phenomenal growth.
Behavioral inter vention strategies that were considered strictly
experimental a few years ago are now accepted therapeutic
modalities, and behavioral method ology has been instrumental in
creating an atmosphere conducive to the development of scientific
rigor in the area of mental health. But behav ioral influence has
not been limited to mental health. There has been considerable
impact in education, industry, government, and general health care.
Although behavior modification has made a significant impact on
psychology in general, there has been a noticeable lack of
theorizing and empirical research on issues primarily related to
black populations. In fact, the black community in general, and
black psychologists in partic ular, often have viewed behavioral
approaches with suspicion. We hope that the material presented in
this volume will serve to clarify what the behavioral approach is
and what it is not and that it will help to foster an understanding
of the behavioral approach. Moreover, empirical data demonstrating
the effectiveness of behavioral procedures with black populations
are presented. It is our hope that the material will provide some
insight into how behavioral theory, methodology, and therapeutic
strategies can be used to the benefit of black mental health in
particular and the overall psychological health of the black
community in general."
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