{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,9]],"date-time":"2026-04-09T16:49:58Z","timestamp":1775753398237,"version":"3.50.1"},"reference-count":27,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2026,1,29]],"date-time":"2026-01-29T00:00:00Z","timestamp":1769644800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,1,29]],"date-time":"2026-01-29T00:00:00Z","timestamp":1769644800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Clin Psychol"],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>Exposure and response prevention (ERP) remains the gold\u2010standard psychotherapy for obsessive\u2013compulsive disorder (OCD), yet real\u2010world care is limited by dropout, partial response, relapse, and phenotypes that strain habituation\u2010centric protocols. This commentary synthesizes five case reports that upgrade ERP not by replacing it, but by refining how inhibitory learning is taught and enacted. In the first case study Capel and Twohig 2025, Acceptance and Commitment Therapy (ACT) with values\u2010based exposure shifted the goal from distress reduction to values\u2010consistent action under aversive private events, boosting motivation and generalization. In the second case (Wille et al. 2025), VR\u2010assisted avatar therapy externalized the OCD voice\u201d, boosting insight and resistance to compulsions and thereby unlocking ERP. In the third case (Micheli and Melli, 2026), addressing mental contamination, imagery rescripting reframed shame and disgust. In the fourth case (Jessup et al. 2024), ERP was tuned to emphasize clear expectancy violations and to vary contexts. In the fifth and final case study Fausting et al. 2025, the focus was on \u201cinnovative moments\u201d during ERP. Noticing and amplifying these small, natural shifts (\u201cexceptions\u201d) kept the client engaged and helped solidify new response patterns. Together, these vectors suggest a next wave of OCD care: precise personalization of ERP's mechanism (expectancy violation\/inhibitory learning), process targets (motivation, insight, psychological flexibility and non\u2010fear emotions like shame and disgust), and format (tech\u2010assisted delivery), evaluated with mechanism\u2010linked outcomes. Rather than \u201cmore ERP,\u201d the field should engineer better operating conditions for ERP\u2014one explicit prediction, one values\u2010anchored action, and one reinforced micro\u2010gain at a time.<\/jats:p>","DOI":"10.1002\/jclp.70098","type":"journal-article","created":{"date-parts":[[2026,1,29]],"date-time":"2026-01-29T18:24:11Z","timestamp":1769711051000},"page":"810-816","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["From Exposure to Insight: Lessons From Five Contemporary OCD Cases and Where Treatment Should Go Next"],"prefix":"10.1002","volume":"82","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4384-4903","authenticated-orcid":false,"given":"Jakob","family":"Fink\u2010Lamotte","sequence":"first","affiliation":[{"name":"Clinical Psychology University of Potsdam Potsdam Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2026,1,29]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcbs.2022.03.007"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0005-7967(98)00173-9"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.beth.2011.03.007"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/jclp.23759"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1177\/1740774514536795"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbtep.2013.09.001"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.brat.2014.04.006"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1176\/ajp.155.1.102"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/jclp.23797"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jocrd.2021.100684"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jocrd.2020.100524"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.1093\/med:psych\/9780195335286.001.0001"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.1146\/annurev-clinpsy-032210-104533"},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.1080\/10503307.2021.2003463"},{"key":"e_1_2_12_16_1","doi-asserted-by":"publisher","DOI":"10.1001\/archpsyc.1989.01810110054008"},{"key":"e_1_2_12_17_1","doi-asserted-by":"publisher","DOI":"10.4103\/psychiatry.IndianJPsychiatry_516_18"},{"key":"e_1_2_12_18_1","doi-asserted-by":"publisher","DOI":"10.1002\/jclp.23758"},{"key":"e_1_2_12_19_1","doi-asserted-by":"publisher","DOI":"10.1001\/archpsyc.62.6.593"},{"key":"e_1_2_12_20_1","doi-asserted-by":"publisher","DOI":"10.1002\/jclp.70083"},{"key":"e_1_2_12_21_1","doi-asserted-by":"publisher","DOI":"10.1097\/NMD.0000000000000156"},{"key":"e_1_2_12_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.brat.2025.104810"},{"key":"e_1_2_12_23_1","unstructured":"Rothkegel L. O. M. S.Bordjian\u2010Boroudjeni N.Reinoso\u2010Schiller G. C. L.Davey andJ.Fink\u2010Lamotte Under Revision. Beyond Unidimensionality: Development and Validation of the Multidimensional State Disgust Questionnaire (MSDQ).https:\/\/osf.io\/5w8x2\/overview?view_only=3bf51fa2f3f546e0a12ed3ac166135dd."},{"key":"e_1_2_12_24_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13063-022-06683-1"},{"key":"e_1_2_12_25_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10578-023-01548-3"},{"key":"e_1_2_12_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.brat.2018.06.005"},{"key":"e_1_2_12_27_1","unstructured":"Wilhelm S. andG.Steketee(2006).Cognitive Therapy for Obsessive Compulsive Disorder: A Guide for Professionals.New Harbinger Publications."},{"key":"e_1_2_12_28_1","doi-asserted-by":"publisher","DOI":"10.1002\/jclp.23772"}],"container-title":["Journal of Clinical Psychology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jclp.70098","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/jclp.70098","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jclp.70098","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,9]],"date-time":"2026-04-09T15:54:53Z","timestamp":1775750093000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/jclp.70098"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1,29]]},"references-count":27,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2026,5]]}},"alternative-id":["10.1002\/jclp.70098"],"URL":"https:\/\/doi.org\/10.1002\/jclp.70098","archive":["Portico"],"relation":{},"ISSN":["0021-9762","1097-4679"],"issn-type":[{"value":"0021-9762","type":"print"},{"value":"1097-4679","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1,29]]},"assertion":[{"value":"2025-11-10","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-01-13","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-01-29","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}