A 27-year-old woman presents to her family physician with an 18-month history of intrusive fears of contamination from germs and bodily fluids. She washes her hands for more than 2 hours each day, has taken sick leave from her office job after repeatedly arriving late, and her hands are painful. She recognizes that the fear and washing are excessive but cannot stop. On examination, both hands have erythema, dryness and fissuring. She denies low mood, hallucinations, periods of elevated mood, suicidal thoughts, and alcohol or drug use. She takes no medications and has no known drug allergies. She would prefer to avoid medication at this time.
| Heart rate | 76/min |
| Respiratory rate | 14/min |
| Temperature | 36.8 °C |
| O2 saturation | 99%, room air |
| Blood pressure | 112/70 mm Hg |
Question 1 of 3
Which one of the following is the most appropriate first-line psychotherapy for this patient?
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