This manuscript is one in a series of invited papers to this journal. The purpose of the series is to highlight and discuss the similarities and differences between various behavioral and cognitive-behavioral approaches to the treatment of obsessive-compulsive disorder (OCD). The first article in this series (Twohig & Whittal) describes the case of "Caroline" upon which the current manuscript is based. We approach the case from a cognitive-behavioral orientation with exposure and ritual prevention (EX/RP) as the primary therapeutic approach. We highlight the use of EX/RP because of the considerable body of empirical evidence showing that EX/RP is an efficacious treatment for both adult and pediatric OCD. Using the provided case vignette, we outline a rationale for EX/RP and describe how EX/RP might be used to treat Caroline's OCD. We begin by discussing the theoretical underpinnings for EX/RP and providing a rationale for treatment. We then briefly discuss the rich extant literature supporting EX/RP as an effective treatment for OCD. We then provide a detailed case conceptualization and description of the treatment. We conclude with barriers commonly encountered during EX/RP. (Contains 4 tables.)