What do therapists and clients do during exposures for OCD? Introduction to the special issue on theory-based exposure process

Cognitive behavioral therapy (CBT) is the empirically supported psychotherapy of choice for obsessive-compulsive disorder (OCD). Exposure, which involves intentionally confronting a feared stimulus, is presumed to be a core procedural ingredient of CBT for OCD. Unfortunately, existing treatment manuals give little guidance about optimal exposure process in terms of proscribed and prescribed therapist and client behaviors. The current article discusses the importance of exposure process in terms of improving our understanding of CBT mechanisms and variable outcomes, as well as to dissemination and training efforts. A hypothetical case example is presented and will be used in subsequent articles to discuss exposure process from several CBT-based theoretical models.