Clinical Feedback About Empirically Supported Treatments for Obsessive‐Compulsive Disorder Nicholas C. Jacobson Michelle G. Newman The Pennsylvania State University Marvin R. Goldfried Stony Brook University Previous evidence for the treatment of obsessive‐compulsive disorder (OCD) has been derived principally from randomized controlled trials. As such, evidence about the treatment of OCD has unilaterally flowed from researchers to clinicians. Despite often having decades of experience treating OCD, clinicians’ feedback on their clinical observations in using these treatments has not been solicited. The current study contacted clinicians for their clinical observations on empirically supported treatments for OCD to identify commonly used cognitive-behavioral techniques and their limitations in their practices. One hundred eighty-one psychotherapists complet- ed an online survey. The average participant practiced psycho- therapy for 15 years, worked in private practice, held a doctorate, and treated an average of 25 clients with OCD in their lifetime. In regard to the most common techniques, behavioral strategies involving exposure to a feared outcome and prevention of a compulsive ritual were the most frequent group of interventions, followed by techniques that attempted to identify and challenge irrational thoughts. However, the majority of participants also reported incorporating mind- fulness or acceptance-based methods. Based on therapists’ reports, the most common barriers to the efficacy of cognitive-behavioral interventions included limited premor- bid functioning, chaotic lifestyles, controlling and critical families, OCD symptom severity, OCD symptom chronicity, and comorbidities. This study provides insight into common practices and limitations in clinical practice to inform future clinically relevant treatment research. Keywords: dissemination; obsessive‐compulsive disorder; empiri- cally supported treatment; clinical trials OBSESSIVE-COMPULSIVE DISORDER (OCD) IS defined by intrusive and recurrent thoughts, images, or desires that cause marked distress, which are ignored or nullified through rigid rules or repetitive behaviors (American Psychiatric Association, 2013). The an- nual prevalence of OCD is estimated to be 1.1–1.8% across cultures (Weissman et al., 1994), and typically has a bimodal age of onset, occurring frequently before the age of 10 and after the age of 17, with cases of earlier onset coinciding with more symptoms and higher comorbidity rates (Rosario-Campos et al., 2001). A large proportion of persons with OCD have lifetime diagnoses of other anxiety disorders (76%), depressive disorders (40%), bipolar disorder (23%), impulse disorders (56%), and substance abuse (39%; Ruscio, Stein, Chiu, & Kessler, 2010). Comorbidity is also associated with more OCD symptoms compared with those without comorbidity. Perhaps most significantly, even without comorbidity, OCD is associated with substantial life impairment and distress (Huppert, Simpson, Nissenson, Liebowitz, & Foa, 2009; Ruscio et al., 2010). In regard to its symptoms, prominent theories on the mechanisms of OCD include thought–action fusion and maladaptive beliefs (Williams, Lau, & Grisham, 2013) as well as behavioral reinforcement Available online at www.sciencedirect.com ScienceDirect Behavior Therapy 47 (2016) 75 – 90 www.elsevier.com/locate/bt Address correspondence to Nicholas C. Jacobson, The Pennsylvania State University, 378 Moore Building, University Park, PA 16802-3103; e-mail: njacobson@psu.edu. 0005-7894/© 2015 Association for Behavioral and Cognitive Therapies. Published by Elsevier Ltd. All rights reserved.