To evaluate variables influencing the treatment of compulsive rituals, five patients with discrete rituals were studied while treatment conditions were systematically varied. Both behavioral and subjective measures were taken. Observation of these patients suggests that expectancy of improvement, exposure, and instructions were not sufficient conditions for the elimination of rituals, although these variables influence change in interaction with the prevention of the response for a period of time.
In each case there was a dramatic reduction in the rate of the ritualistic behavior after a period of response prevention. In each of the cases the reduction in the compulsive ritual was maintained after release, although in two of the five cases further intervention was necessary.
Mills HL, Agras WS, Barlow DH, Mills JR. Compulsive Rituals Treated by Response PreventionAn Experimental Analysis. Arch Gen Psychiatry. 1973;28(4):524-529. doi:10.1001/archpsyc.1973.01750340058010