Which intervention best supports reducing ritualistic behavior in a client with obsessive-compulsive disorder?

• A. Allow uninterrupted ritual time whenever patient requests.
• B. Ignore the ritual and avoid discussing it.
• C. Create a structured schedule with limited time for ritual.
• D. Remove all supports for anxiety.

Answer: (C)

Limiting ritual time through a structured schedule uses the idea of exposure with response prevention in practice. In OCD, performing rituals briefly relieves anxiety, which reinforces the urge to ritualize. By creating a predictable routine and giving a defined, gradually shrinking window for rituals, you reduce how often and how long the rituals occur while teaching the client to tolerate anxiety without performing the ritual. This approach helps break the automatic link between distress and ritual action, supporting longer-lasting improvement as the person learns to endure the urge. For example, start with a brief, fixed ritual window and gradually extend the time between rituals while offering coping strategies and distraction during the waiting periods. Allowing uninterrupted ritual time would reinforce the behavior, and ignoring the ritual or removing all supports for anxiety can leave the client without useful strategies to cope, potentially worsening distress.