Inference-based Cognitive Behavioral Therapy (I-CBT)

Inference-based Cognitive Behavioral Therapy (I-CBT) is an evidence-based treatment based on the central idea that obsessions are abnormal doubts or inferences. According to this approach, obsessional inferences of doubt arise as the result of a reasoning narrative characterized by an over-reliance on the imagination and a distrust of the senses. I-CBT aims to bring real resolution to obsessional doubts by showing the client that obsessional doubts arise as the result of a distorted obsessional narrative.

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I-CBT is a newer evidence-based treatment for OCD and is known as a "gentler" approach compared to ERP. I-CBT uses your inherent strengths and wisdom of your own mind and body. It does so by teaching you to rely less on long-programmed default modes of reasoning (doubt-based) and fearful imagination, and more on your 5 senses, wise mind, and sense of self.

— Jenn Huntting, Licensed Clinical Mental Health Counselor Associate in Tacoma, WA

Anxiety tells scary things are always possible, maybe even likely going to happen! What if they do? Anxiety wants us to respond to these possibilities, because after all, they COULD happen. ICBT helps us learn to distinguish the present moment we can sense, AKA, the here and now, from our imagination, so we can better determine when we are getting sucked into a scary story that we feel we need to act on. When we learn this, we become free from obsessing on what could be, and live in what is.

— Katrina Tattenham, Licensed Clinical Social Worker in Santa Cruz, CA
 

I have attended multiple trainings run by early adopters of I-CBT in the United States. I also participate in an I-CBT consultation group with a clinician who developed many of the materials used by I-CBT clinicians and clients. In 2023, as part of OCD Awareness Week, I presented on I-CBT as part of an "Ask the Experts Panel."

— Meghan Meros, Licensed Professional Clinical Counselor

Inference-based CBT has over 20 years of research and is an emerging model in the US. ICBT thinks about OCD differently than other therapy models in that it posits obsessions and the faulty reasoning process as what drives the OCD cycle. Intrusive thoughts are not random, they are constructed, which means you can learn to de-construct OCD. It is highly effective at treating OCD and is more of a cognitive model. You can read more about it here: https://icbt.online/what-is-icbt/

— Sarah Weber, Mental Health Counselor in Spokane, WA
 

As a person who lives with OCD, who has used ACT and ERP, I felt something was missing from each modality that I couldn't seem to figure out until I discovered Inference Based CBT. While traditional CBT is often not helpful for Neurodivergent individuals, I-CBT is different in that it encourages us to seek the root of the obsessional thought patterns to help support the underlying need in order to keep these looping thoughts from occurring at the intensity they have been at their source.

— Cherish Graff, Licensed Professional Counselor