Clinical Round Table 5 - Comorbid OCD+PTSD: Conceptualization and Treatment Recommendations for Exposure Therapy

Obsessive-compulsive disorder (OCD) and posttraumatic stress disorder (PTSD) frequently co-occur, presenting unique challenges in conceptualization and treatment. While both disorders involve maladaptive avoidance and distress intolerance, their symptom structures differ, and their comorbidity is associated with greater severity and poorer treatment response. Recent research supports an integrated approach for OCD+PTSD by combining disorder-specific exposure-based interventions, namely exposure and response prevention (ERP) and prolonged exposure (PE). This clinical round table will bring together six clinical psychologists with extensive clinical, research, and educational experience in OCD, PTSD, and exposure therapy. Presenters have experience with children and adults with OCD+PTSD in range of settings including private practice, academic medical centers, and veterans affairs. A moderated discussion will present the audience with recent empirical evidence related to exposure therapy for OCD+PTSD including findings on mechanisms of change, predictors of treatment response, and how to combine elements from ERP and PE. The presenters will translate empirical research into actionable clinical recommendations and identify gaps in the literature that warrant further investigation. Strategies will be reviewed to maintain treatment fidelity while practicing flexible and identity-affirming care, particularly with patients from marginalized groups (e.g., racial, ethnic, gender, sexuality, and religious groups). Opportunities to innovate within both the clinic and research lab will be highlighted. The final portion of the clinical round table will include presenters offering live consultation on real-world cases offered by the audience, allowing attendees to engage with experts and refine their clinical decision-making. All discussions will emphasize considerations for diverse and underrepresented populations, including groups more vulnerable to trauma exposure. By bridging the latest research and practice, the clinical round table will offer clinicians practical tools to improve patient outcomes and enhance the implementation of exposure-based interventions in a wide range of settings and patient populations.