Inference-based cognitive behavioral therapy or I-CBT (sometimes also referred to as IBT) is a therapy designed to treat obsessive compulsive disorder (OCD). I-CBT is an evidence-based treatment that sees obsessions as abnormal doubts (eg. I might be a pedophile, I might have left the stove on, I might be contaminated) that arise from a narrative that is formed from an over-reliance on the imagination and a mistrust of the senses.
The goal of treatment for I-CBT is to help the person with OCD resolve their obsessive doubts by learning how they were formed and why they are obsessive rather than reasonable. As stated on the I-CBT website (https://icbt.online/what-is-icbt/), I-CBT “encourages those with OCD to develop alternative narratives that are more in line with reality and the senses. Throughout treatment, the client is encouraged to trust their inner and outer senses during reasoning. They already do so in most non-obsessional situations so there is nothing to learn except to reclaim and rediscover their authentic and real selves.”
I-CBT has twelve modules that target different ways to conceptualize and resolve obsessive doubts including fears about the self and who a person is afraid of becoming. I-CBT can be a helpful treatment option for people who have not responded well to other forms of treatment for OCD. It does not require exposure and does not focus on reducing compulsions. The elimination of compulsions is a natural consequence of resolving the doubt. For example, if I no longer doubt I left the stove on, I will feel not need to check and recheck the stove.
As a therapist, I love using I-CBT because helping people learn to trust themselves, their senses and common sense is in alignment with my own values of seeing people as whole, capable human beings rather than broken people who need fixing. It is also amazing to watch people with OCD rediscover their real self and let go of fears of who the OCD narrative says they could become if they fail to do compulsions.
While learning to use I-CBT, I have found the community of therapists and trainers using I-CBT lovely to engage with. There is an unprecedented amount of collaboration, information and resource sharing among this community. Many of the biggest proponents of this form of therapy are therapists who have lived experience with OCD and are passionate about making sure people choices when it comes to their treatment. I began learning this modality in 2022 and have been able to ask questions and receive training from one of the founders, Frederick Aardema, as well as the people he has trained.
To learn more about I-CBT you can visit their website at https://icbt.online/.
Sarah Hunter, LCSW 