OBSESSIVE-COMPULSIVE DISORDER
Obsessive-Compulsive Disorder (OCD) affects 1% of the US population, that is 1 out of every 100 people. OCD is a mental health condition in which the individual experiences obsessions and compulsions. Obsessions are unwanted and repetitive thoughts, images, or impulses that persist and create great discomfort or anxiety despite efforts to push them away. People with OCD believe that because they are having the thoughts, images, or impulses, that there must be some truth to them; they interpret them as dangerous. Therefore, they do not want them and engage in behaviors meant to decrease their anxiety or “undo” their obsessions. These behaviors are compulsions. Although compulsive behaviors are not always logically related to obsessions, individuals with OCD feel compelled to engage in these behaviors, which provide short term relief, but increase their anxiety in the long term. Symptoms of OCD vary widely, but may include one or more of the following:
• Excessive fear of germs
• Repetitive washing of body or hands, lengthy cleaning rituals
• Repetitive thoughts about harming loved ones, without a desire to act
• Repetitive prayers or religious actions, preoccupation with being immoral or blasphemous
• Perfectionism
• Checking and re-checking, such as to be certain that doors and windows are locked, and oven, lights or other appliances are off
• Distress about lack of symmetry or organization
• Excessive efforts to order objects or arrange surroundings
• Preoccupation with counting, magic numbers, specific colors or sequences of movement
• Repetitive concerns that one is not the sexuality or gender with which they identify (e.g., if heterosexual, believes they are secretly homosexual despite evidence to the contrary)
• Other obsessions or compulsions that lead to severe anxiety or disrupt daily life
Treatment
We, at The OCDGlobal, specialize in the treatment of this pervasive mental health condition, and have the necessary training and resources to deliver evidence-based treatment to OCD sufferers of all ages, as well as those with comorbid Autism Spectrum Disorders as well as other mental health issues. More than 40% of the clients that we treat suffer from OCD. The most effective treatment for OCD, the gold standard, is a type of Cognitive Behavioral Therapy called Exposure with Response Prevention (ERP). Research has shown that for individuals with mild to moderate OCD, an effective dose of ERP is the first line treatment for OCD. For individuals with more severe OCD, medications along with ERP is the most effective first line treatment approach. Through ERP, individuals with OCD learn to face their anxiety while decreasing their compulsions, helping them gradually gain their lives back from OCD. Treatment typically begins with an assessment of your symptoms and psycho education about OCD and what maintains it.
It proceeds with some cognitive therapy, preparing for and conducting various exposures and associated processing of learning, implementing response prevention, and relapse prevention. Client’s will also learn strategies for tolerating discomfort and anxiety. Family support and parent training are also a large portion of the treatment when necessary. We also occasionally incorporate components of mindfulness-based cognitive behavioral approaches such as Acceptance and Commitment Therapy (ACT) and Dialectical Behavioral Therapy (DBT) into the ERP protocol if indicated or requested by our clients. If ERP sounds scary to you, you are not alone. Therapists are with you during the process and will do the exposures with you during the session before they assign you practice. Exposures are done gradually and systematically. Therapists will work with you to design exposures that are tolerable and to help you feel as successful in the process as possible. We are very passionate that ERP is an effective and safe mode of treatment and feel strongly that with an effective dose of treatment, you can manage OCD so that you can get back to your life. A great percentage of our clients are able to manage OCD such that it is not interfering with their lives, and they are able to live happy, productive lives. Please see our Exposure and Response Prevention page for further information.
What if My Child or Loved One will not Engage in Treatment?
Oftentimes, loved ones are reluctant or resistant to engage in treatment, and we can meet with family members to begin the treatment process without the child or significant other. During this process, we provide education and information about OCD and what maintains it, how to talk about OCD, how to help family members engage in treatment, review environmental factors that are contributing to the OCD, and help families reduce these factors. We can help parents by role playing with them on how to respond when their child is anxious and how to begin to set up treatment at home. We can also help parents set up reward plans that work to help their children engage in the treatment process as well. A lot of progress can be made this way. It is not uncommon for children to be reluctant or to refuse to engage in treatment, and this doesn’t mean that they can’t begin the process to getting better!
What About More Intensive Services?
Oftentimes, we are able to treat OCD with one session a week, but sometimes, exposures work more effectively with multiple sessions a week to start. We also offer intensive treatment options for individuals, with the ability to meet with a therapist anywhere from twice a week to multiple hours each day in order to make progress quickly and return to work, school, and everyday life. We have often worked successfully with people who have been in treatment for many years or people who have not benefited as much as they would like from treatment in the past. We find that they, unfortunately, have not been engaged in evidence-based therapy or had a sufficient dose of it. We, at The OCDGlobal, take pride in treating people with more difficult symptoms or presentations.