Inference-Based Cognitive Behavioral Therapy (I-CBT) for OCD
What is I-CBT?
One of the newer evidence based treatments for OCD, I-CBT (Inference-Based Cognitive Behavioral Therapy) is a cognitive approach that was developed in the late 1990’s. I-CBT can be used either alongside Exposure and Response Prevention (E/RP) therapy to enhance treatment or as an alternative for individuals who prefer a non-exposure-based approach. A primary goal of I-CBT is to help those with OCD foster greater understanding of how OCD-related doubts and fears are created. You learn to understand the “behind the scenes” of OCD, revealing how OCD works and what makes specific obsessions feel so “sticky.” In I-CBT you gain a better understanding of the differences between how your mind reasons in everyday parts of life that are unaffected by OCD, versus how your mind reasons in areas of life impacted by OCD. Ultimately, I-CBT aims to teach you why and how you are getting stuck in OCD, while simultaneously rebuilding trust in yourself so you can get “unstuck.”
What are some of the main strategies used in I-CBT?
One of the first concepts discussed in I-CBT treatment is the idea of “Inferential Confusion.” From an I-CBT perspective, OCD-related doubts arise after you have made an inference, or conclusion, based on a faulty reasoning process. I-CBT helps you identify the main reasoning errors that lead to obsessional doubt.
Another key strategy of I-CBT treatment is “Reality Sensing.” Reality sensing is the process of learning to trust the information you have in front of you (through your five physical senses, common sense, values, beliefs, emotions) and staying grounded in this information. I-CBT teaches you how to identify when your mind has gotten stuck in Inferential Confusion and entered the “OCD Bubble,” and how to instead stay grounded in the present moment through Reality Sensing.
Another core concept of I-CBT is called the “Feared Possible Self.” The Feared Possible Self is essentially just what it sounds like – the type of person that OCD leads us to fear that we are or could become. For example, if a person has obsessions such as “What if I accidentally told a lie at some point in my life?” they may have the “Feared Possible Self” of being a dishonest or immoral person. I-CBT supports you in acknowledging this Feared Possible Self, while alternatively reflecting on who you truly are, based on your values, experiences, everyday actions.
What can I expect in an I-CBT session?
While I-CBT will be tailored to each individual’s needs and goals, generally treatment will be focused on twelve modules, each of which introduces a new cognitive strategy or concept related to OCD. I-CBT primarily focuses on understanding the “why” and “how” of the OCD process, with the idea that gaining this insight can decrease the intensity of obsessions and urgency to address them. Each module of I-CBT will support you in better understanding how OCD works, where you are getting stuck, and how to build self-trust rather than staying stuck in a “what if” question. I-CBT often works best when practicing the concepts and skills between sessions, so your therapist may give you between-session “homework” to reinforce the skills discussed in session. Your therapist will be focused on taking an “upstream” approach to stopping the cycle of OCD by exploring with you why the initial doubts do not need your attention in the first place.
Is I-CBT right for me?
AATC has therapists with specialized training in I-CBT for OCD. If you are interested in learning more about I-CBT treatment to see if it may be right for you, please reach out via our contact page. We are happy to offer a free 15 minute consultation to answer any questions!
Sources:
Aardema, Frederick & O’Connor, Kieron. 2017-2026. Retrieved from https://icbt.online/.