Inference-Based Cognitive-Behavioral Therapy (I-CBT)

[Giusss]

Hi everybody. Does anyone know and could explain to me what Inference-Based Cognitive-Behavioral Therapy (I-CBT) is? Thank you very much.

[Handy]

Inference-based cognitive behavioral therapy (I-CBT) is a type of therapy that is specifically designed to treat obsessive-compulsive disorder (OCD) and related conditions.

 

**How does I-CBT work?**

 

I-CBT is based on the idea that obsessions are caused by a type of reasoning error called "inferential confusion." Inferential confusion is when someone mistakes a possibility for a probability. For example, someone with OCD might have the obsession that they left the stove on and will burn down their house. This obsession might be based on the fact that they vaguely remember turning on the stove. However, in reality, it is just as likely that they turned the stove off.

 

I-CBT helps people with OCD to identify and challenge their inferential confusion. It also helps them to develop more realistic thinking patterns. In doing so, I-CBT can help to reduce the distress and impairment caused by OCD.

 

Here are some of the key techniques used in I-CBT:

 

* **Identifying inferential confusion:** The therapist will help the person to identify the specific thoughts and beliefs that are underlying their obsessions.

* **Challenging negative thoughts:** The therapist will help the person to challenge the accuracy and helpfulness of their negative thoughts.

* **Developing more realistic thinking patterns:** The therapist will help the person to develop more realistic and balanced thinking patterns.

* **Exposure and response prevention (ERP):** ERP is a type of therapy that can also be helpful for people with OCD. ERP involves exposing the person to their triggers and preventing them from performing their compulsions.

 

**I-CBT vs traditional CBT**

 

I-CBT is a different type of CBT than the traditional form of CBT that is used to treat OCD. Traditional CBT focuses on identifying and challenging the negative thoughts and beliefs that contribute to OCD symptoms. I-CBT, on the other hand, focuses on identifying and challenging the reasoning errors that contribute to OCD symptoms.

 

**Benefits of I-CBT**

 

I-CBT has been shown to be an effective treatment for OCD. It can help to reduce the severity of obsessions and compulsions, and improve quality of life. I-CBT is also a relatively short-term treatment, with most people seeing significant improvement in 12-16 weeks.

 

[snowbear]

On 22/03/2024 at 13:04, Giusss said:

Does anyone know and could explain to me what Inference-Based Cognitive-Behavioral Therapy (I-CBT) is?

Handy has given you the information you'll get if you google it.

Personally I think it's just 'CBT'. All these new 'types' of CBT are a bit of a misnomer - it's all just CBT.

The whole point of CBT is that it adapts to the individual needs of each client, so giving each part of the process new names just confuses people IMO. Not unlike some people still talk about HOCD,ROCD, SOCD and Pure O They're all just plain old OCD and the extra letter adding in what the person's obsessions are about is irrelevant. 

Same with i-CBT. It's just CBT, with more emphasis on a particular part of the process at the start - and (if the therapist is worth their pay packet) the CBT will adapt as you progress so it remains specific to you as an individual and covers all the needs which are revealed through the sessions.

They've started to give different aspects of CBT these new names because CBT is now well-established as a therapy and focusing on a single aspect of it is the only way psychologists new to the field can get their name attached to 'new' research.   Really they're just proving (again!) that CBT works while trying to gain some kudos and reputation off the back of their 'not-so-new-'new' research.

If you've been told i-CBT is what's on offer, say thank you very much and get stuck in.

[Giusss]

Thank you for your answers. I can't find any studies in Italian (my mother language). I can only find studies in English, so I think my difficulty in understanding is made worse by the language factor. I don't understand the difference, I can't... The purpose is the same, but the approach changes in something. However, I can't, like, make this approach my own, understand it in depth. Maybe I should search and check online for the modules used in that approach.

I am just curios. Here in Italy (or maybe all over Europe, who knows) you can't find psychotherapists who use I-CBT, as far as I know.

I found this website: https://icbt.online/ but I need to understand how they carried out studies and research to prove its effectiveness, on how many patients, for how long, etc. etc. And I also need to see where they published those studies. We all know that by paying, you can also publish bullsh*t.

I also read, I don't remember where, that in this way the first part of the ERP, that is, the exposure, can be avoided.

In general, I agree with you, snowbear, at the end of the day CBT is constantly being improved or, rather, adapted to patients, but it is still CBT.

On Instagram there are young American women suffering from various types of OCD who share their experiences, and many of them say positive things about I-CBT, as if it works miracles after just a few modules. But will it be true? And will it last? And how long will it last? In any case, they are supportive and give hope, as they now have normal lives. Some of them are studying to become psychotherapists specialising in obsessive compulsive disorder, which I find surprising, unbelievable!

Like I said, I'm just curious. And I also worry that it might become a 'fad', an illusion, promising false things. In Italy, for example, there is a doctor who boasts of having healed over 15,000 people with his Brief Strategic Therapy, he writes books, gives lectures, etc. Obviously, since he is based on CBT, he also says proper things, but... I don't know, to me it seems like advertising, a way to make money. I distrust such quick and total healings. Who can say how long they will last? Is there anyone who monitors and keeps the data up to date? After 30 years of torture, I wish it were true. But I don't want to kid myself. Maybe it doesn't work with everyone, that's all.

Medicine is not an exact science and people don't all have the same response. I must accept that. To complicate matters, add the various schools of thought... many psychotherapists and psychiatrists dislike brief strategic therapies, indeed they get very upset. But who should one listen to?

Maybe I'll ask my psychiatrist and psychotherapist to find if they've heard of I-CBT. Or maybe I won't ask... Thanks again.

[Angst]

Hi G

In the UK treatments for mental and physical undertaken or financed in the state socialised medical system, the National Health Service has to be evidenced based. The body that deals with getting the evidence is NICE - National Institute for Clinical Excellence. If you go to their website you will read about their recommendations for the treatment of OCD. Their recommendations for treatment are based upon research published in academic journals which are rigorously peer reviewed that is the research is scrutinised by other academics and researchers to see if the results claimed are evidenced.

I personally see a problem with knowing the efficacy of mental health interventions in that there is a lack of long term follow up of patients who have received treatment. It would be better if a sample of patients were followed up after a year, five years and ten years. This is done, for example, with cancer treatments. There are samples of patients taken which are followed up years after a treatment. That way, we have a more effective way of knowing the effectiveness of a treatment. It could be that simply undergoing therapy and having the undivided attention of a therapist produces a ‘placebo’ effect in the short term.
 

There are many therapies available in the commercial sector. It could be that therapists look for a USP - a unique sales point to differentiate their service from other therapists. You are right to want clinical evidence before you pay for treatment.

In the UK in the private sector, the therapy industry is unregulated. Anybody can call themselves a therapist, a counsellor or a psychologist. That is why OCD UK has a page on its website indicating on how to get a therapist who is a member of a recognised professional association.

[Giusss]

1 hour ago, Angst said:

Hi G

In the UK treatments for mental and physical undertaken or financed in the state socialised medical system, the National Health Service has to be evidenced based. The body that deals with getting the evidence is NICE - National Institute for Clinical Excellence. If you go to their website you will read about their recommendations for the treatment of OCD. Their recommendations for treatment are based upon research published in academic journals which are rigorously peer reviewed that is the research is scrutinised by other academics and researchers to see if the results claimed are evidenced.

I personally see a problem with knowing the efficacy of mental health interventions in that there is a lack of long term follow up of patients who have received treatment. It would be better if a sample of patients were followed up after a year, five years and ten years. This is done, for example, with cancer treatments. There are samples of patients taken which are followed up years after a treatment. That way, we have a more effective way of knowing the effectiveness of a treatment. It could be that simply undergoing therapy and having the undivided attention of a therapist produces a ‘placebo’ effect in the short term.
 

There are many therapies available in the commercial sector. It could be that therapists look for a USP - a unique sales point to differentiate their service from other therapists. You are right to want clinical evidence before you pay for treatment.

In the UK in the private sector, the therapy industry is unregulated. Anybody can call themselves a therapist, a counsellor or a psychologist. That is why OCD UK has a page on its website indicating on how to get a therapist who is a member of a recognised professional association.

Hello! I'm absolutely on the same page as you. There has to be follow up for us too! Thanks also for the info, I will check the NICE website. 

[Angst]

Hi G

Just looked at the NICE recommendations. It is not updated much. CBT is still recommended along with the suggestion that in addition Acceptance and Commitment might be more helpful than progressive relaxation. Most interesting was family therapy together with CBT for 13 to 24 year olds in a longitudinal study studying patients over seven years period with a high percentage of patients recovering from OCD. There were problems as in all these studies about getting patients to commit to long term research. There was a lot of research stuff on medications and teletherapy.

Edited March 25 by Angst

[deValentin]

In a nutshell, I-CBT treats OCD more as a belief disorder, whereas ERP relies more on habituation to treat OCD. They are both a form of CBT, but the emphasis is different. 

[Giusss]

Hi Angst and deValentin. Thanks for your replies. Today is a bad day and I can't understand anything... I'm in the grip of one of the worst obsessions of us sufferers (pocd). Luckily I had an appointment with my psychiatrist in the afternoon and I finally decided to try another drug. I'm shattered.

Well, it'll pass. Thanks for the info. For sure when I get a bit more clear-headed (hopefully soon), I'll treasure your answers and delve into the subject. Thanks again for your help.

[Handy]

Medication doesn't cure OCD, nor can it affect thoughts or actions, it just mutes ones response emotionally.  Medication is not the first treatment choice for most OCD patients according to OCDUK.

Getting a blood panel is worth it to see if there is anything that can be adjusted.

[Giusss]

8 hours ago, Handy said:

Medication doesn't cure OCD, nor can it affect thoughts or actions, it just mutes ones response emotionally.  Medication is not the first treatment choice for most OCD patients according to OCDUK.

Getting a blood panel is worth it to see if there is anything that can be adjusted.

Nobody says medication is the first treatment. In many cases you need to take it, period. They help, they work. Where does OCDUK say it's not the first treatment choice for MOST patients? According to the scientific community that's not completely true. It depends on patients conditions. And nothing must be adjusted in my blood panel, thanks for your advice 

[Giusss]

9 hours ago, Handy said:

Medication doesn't cure OCD, nor can it affect thoughts or actions, it just mutes ones response emotionally.  Medication is not the first treatment choice for most OCD patients according to OCDUK.

Getting a blood panel is worth it to see if there is anything that can be adjusted.

Psychotherapy is the first approach, but it is not always the only one. Very often it is supplemented by medication, which, depending on the single patient, can be reduced and then removed, or taken for life. Extremism, generalisations and denialism are not my cup of tea. Ignoring or manipulating reality to suit one's own opinions is harmful. We need real data, not fake news. And mental illnesses must be considered and treated like organic ones, without shame and without anti-scientific theories. 

[Handy]

17 hours ago, Giusss said:

 And mental illnesses must be considered and treated like organic ones, without shame and without anti-scientific theories. 

Absolutely.  So, it baffles me we  can't type about OCD therapy methods on the forum. But there used to be loads of POCD content, pretty edgy stuff in my opinion.

My answer wasn't written by Google because it referenced no page. It's more a gathering of information.

[OCD_Guy_UK]

I heard of i-cbt only recently and am certainly intriged by it. There's some stuff on YouTube. Whilst i think it could possibly help in a way, i still doubt one could use it on its own.

[Handy]

On 26/03/2024 at 02:28, Giusss said:

Nobody says medication is the first treatment. In many cases you need to take it, period. They help, they work. Where does OCDUK say it's not the first treatment choice for MOST patients? According to the scientific community that's not completely true. It depends on patients conditions. And nothing must be adjusted in my blood panel, thanks for your advice 

No Google in UK? Ok this is the page I found with Google in USA:

https://www.ocduk.org/overcoming-ocd/medication/

[PolarBear]

On 25/03/2024 at 17:49, Handy said:

Medication doesn't cure OCD, nor can it affect thoughts or actions, it just mutes ones response emotionally.  Medication is not the first treatment choice for most OCD patients according to OCDUK.

Getting a blood panel is worth it to see if there is anything that can be adjusted.

I don't know where you get this idea that meds don't affect thoughts. Some people see a reduction in the frequency and severity of obsessions on meds.

[OCD_Guy_UK]

I don't think any treatment works for everyone or otherwise they'd be just one medication for ocd. We've got to try and see what works for us.

[Giusss]

16 hours ago, OCD_Guy_UK said:

I don't think any treatment works for everyone or otherwise they'd be just one medication for ocd. We've got to try and see what works for us.

 

I agree 100% 

[Giusss]

On 31/03/2024 at 00:46, Handy said:

No Google in UK? Ok this is the page I found with Google in USA:

https://www.ocduk.org/overcoming-ocd/medication/

Thank you for your reply. Mine was a serious question, so I don't understand your irony. I don't understand why you get defensive by attacking... guilty conscience or did you misunderstand me? After all, you can't hear the tone of voice in chat. Ah, I know Google is used in the UK but, as you can see, I don't live there, and you can find it out without having to google. I also remind you that I wrote "Nobody says medication is the first treatment." You've quoted it... do you quote without reading? I really don't understand you. Well, have a nice day.

Edited April 1 by Giusss