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Although ERP is currently considered the gold\u2010standard, first\u2010line psychological treatment, individuals with chronic fluctuations in symptom presentations or especially severe cases may require additional supplements to exposure that maximize learning and facilitate greater generalization of learning experiences. The present case study serves as an example of how traditional aspects of exposure\u2010based CBT (e.g., psychoeducation, hierarchy building, functional analysis, homework) can be successfully used in addition to leveraging more contemporary stylistic modifications (e.g., explicit expectancy violation, context variability) that may optimize treatment in complex or difficult cases. In the present case study of a patient with contamination\u2010based OCD, functional impairment and disorder symptoms responded to treatment and remained improved at a 3\u2010month follow\u2010up. Implications of the case study are discussed and recommendations are offered for clinicians treating complex or challenging OCD cases.<\/jats:p>","DOI":"10.1002\/jclp.23758","type":"journal-article","created":{"date-parts":[[2024,12,13]],"date-time":"2024-12-13T15:43:53Z","timestamp":1734104633000},"page":"182-192","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Strategies for Optimizing Traditional Exposure and Response Prevention: A Case Study Example in an Adolescent With Contamination\u2010Based OCD"],"prefix":"10.1002","volume":"81","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4162-965X","authenticated-orcid":false,"given":"Sarah C.","family":"Jessup","sequence":"first","affiliation":[{"name":"Department of Psychology Vanderbilt University Nashville Tennessee USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amy","family":"Mariaskin","sequence":"additional","affiliation":[{"name":"Nashville OCD and Anxiety Treatment Center Brentwood Tennessee USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3573-4165","authenticated-orcid":false,"given":"Bunmi O.","family":"Olatunji","sequence":"additional","affiliation":[{"name":"Department of Psychology Vanderbilt University Nashville Tennessee USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2024,12,13]]},"reference":[{"key":"e_1_2_5_2_1","doi-asserted-by":"crossref","unstructured":"American Psychiatric Association.2022.Diagnostic and Statistical Manual of Mental Disorders(5th ed. text rev.).https:\/\/doi.org\/10.1176\/appi.books.9780890425787.","DOI":"10.1176\/appi.books.9780890425787"},{"key":"e_1_2_5_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.brat.2022.104069"},{"key":"e_1_2_5_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cpr.2004.08.004"},{"key":"e_1_2_5_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/00005053-199303000-00007"},{"key":"e_1_2_5_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jocrd.2021.100684"},{"key":"e_1_2_5_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.brat.2004.11.007"},{"key":"e_1_2_5_8_1","doi-asserted-by":"publisher","DOI":"10.1037\/0033-2909.99.1.20"},{"key":"e_1_2_5_9_1","first-page":"285","volume-title":"Long\u2010Term Treatments of Anxiety Disorders","author":"Foa E. 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