Response prevention is an intervention that refers to deliberately abstaining from or blocking a compulsion that is normally performed in response to an obsession. This year marks the 60th anniversary of the publication in which response prevention, a behavioural intervention based on learning theory, was first described by Vic Meyer in 1966. Since then, the theory and practice of the intervention have been incorporated into inhibitory learning theory and cognitive behavioural models of obsessive-compulsive disorder (OCD). The theory and principles of resisting a compulsion by tolerating anxiety or uncertainty and testing expectations are straightforward. However, it may be poorly implemented; for example, it is not merely psychoeducation or encouragement as homework to resist a compulsion, but an active therapeutic intervention conducted collaboratively and testing a client’s predictions (Clark, 2020). Various approaches have been described and adopted by clinicians. However, there is remarkably little literature on the optimum approach to response prevention; for example, how it may differ in physical or mental compulsions, how it may be implemented with doubts, and how it may be conceptualised as habitual behaviour. This paper reviews the historical development of response prevention. This review provides clinical guidance on the theory and implementation of this approach and considers areas that require further research.
Key learning aims(1) To understand the phenomenology of compulsions in obsessive-compulsive disorder (OCD).
(2) To formulate the function and termination criteria of a compulsion.
(3) To understand the learning theory and cognitive models to the maintenance of compulsions.
(4) To consider different ways of applying response prevention (response blocking, response reduction, response delay, exposure after a response and habit reversal).
