BOOK
Denis Roberto Zamignani
Post-graduation Program in Clinical Psychology at the University of São Paulo
Vencendo o transtorno obsessivo-compulsivo: manual da terapia cognitivo-comportamental para pacientes e terapeutas
Aristides Volpato Cordioli. Porto Alegre: Artmed, 2004, 166 páginas. ISBN 85-363-0284-4.
In the last years, we had an increasing interest in the media and in the public opinion on issues related to obsessive-compulsive disorders (OCD). This increase is partially due to the unremitting efforts of associations of patients and to the courage of famous people in disclosing in public their stories due to the disease. The endeavor of researchers in this area was the other important part to make the scientific progress available for the lay public, both regarding the medical investigation and the behavioral and cognitive therapies.
This book is an excellent example of this last group. The author presents in a precise, detailed, and simple way, the basic information on OCD, its probable origins and, especially, the behavioral and cognitive strategies aimed to manage the issues related to this diagnosis.
Twelve chapters compose the work, each of them representing a section of a cognitive-behavioral program.
Sections 1 to 5 follow the characteristic stages of this kind of program, including the initial assessment and the information about the disorder (sections 1 and 2), explanations about the technique of exposure with response prevention and its application for each kind of obsessive-compulsive behavior (sections 3 and 4) and presentation of the cognitive strategies (section 5).
In sections 6 to 9 the book unfolds its highest merit: the clear and detailed description of the specificities in the treatment of each of the main groups of obsessive-compulsive symptoms (contamination obsessions - 6; hyper-responsibility - 7; obsessions of improper content - 8; perfectionism - 9). These four 'sections' by themselves would justify the edition of the book, as until now no work in Brazil has brought this contribution.
Section 10 discusses the impact of OCD on the family and its role in the maintenance of the problem, as well as its overcoming, whereas sections 11 to 14 (chapter 11) deal with the treatment's continuity.
Lastly, section 15 presents aspects related to discharge and prevention of relapses.
The book has also some basic information on drug treatment and some symptom-assessing scales and self-monitoring spreadsheets.
Considering all the qualities of the book, it is worth highlighting one aspect that deserves being discussed: the author presents the cognitive-behavioral therapy as 'brief therapy, performed, mostly, in 10 to 15 sections'. Afterwards, the author states that it 'has a short duration and is symptom-focused'. This kind of presentation only reinforces the generalized prejudice that behavioral therapy is limited to a set of symptom-relieving procedures and that, in case patients want a deeper work, they need to seek other psychotherapic approaches. Unfortunately, the author is accompanied by great part of the cognitive-behavioral literature in the divulging of this prejudice.
Nevertheless, what in this book is called cognitive-behavioral therapy corresponds only to a set of techniques (very efficient, by the way), aimed at solving a specific problem. In other words, they are strategies derived from cognitive-behavioral therapy, but not the cognitive-behavioral therapy. This attitude perhaps justifies the author's recommendations (p. 34) about when one must seek this type of therapy ('if the symptoms are severe enough or if you are not sufficiently disciplined to perform the exercises alone'). Borrowing an analogy used by Banaco1 (1999) ' art is being confused with the procedures it utilizes'. Although this may seem a simple question of denomination, it regards to the role assumed by the professional: that of a mere technician which removes symptoms or someone who can offer full therapeutical support to a suffering person.
Reference
1. Banaco RA. Técnicas cognitivo-comportamentais e análise funcional. In: Kerbauy RR, Wielenska RC, orgs. Psicologia comportamental e cognitiva: da reflexão teórica à diversidade na aplicação. Santo André: ARBytes; 1999. vol. 4. p. 75-82.
Publication Dates
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Publication in this collection
30 Mar 2004 -
Date of issue
Mar 2004
