OBSESSIVE COMPULSIVE DISORDER

Obsessive Compulsive Disorder (OCD) affects about 1 in every 40 adults in the United States and about 1% of the child population. OCD is characterized by a cycle of intrusive thoughts or worries (obsessions) and a corresponding urge to take a certain course of action (compulsions). Obsessions may take the form of an image, urge, or thought – all intrusive and unwanted. These thoughts affect the individual on a frequent basis and cause extremely high levels of anxiety. These thoughts don’t go away, but it’s not for want of trying; the individual just can’t rid him/herself of them. Compulsions are the individual’s attempts to get rid of obsessions and the resulting anxiety.

Examples of obsessions

  • Contamination
  • Losing control
  • Accidental harm to self or others
  • Symmetry, exactness, or perfectionism
  • Unwanted sexual thoughts
  • Religious obsessions (scrupulosity)

Examples of compulsions

  • Checking of things, such as locks and appliances
  • Checking that you did not/will not harm others
  • Repeatedly checking in on loved ones to make sure they’re safe
  • Counting, tapping, repeating certain words or numbers
  • Putting things in order or performing a task until it “feels right”
  • Excessive washing or cleaning
  • Making mental lists
  • Mental compulsions such as reviewing your thoughts, feelings, conversations, or actions
  • ‘Un-doing’ something in one’s mind
  • Reassuring oneself that “everything is okay”
  • Asking others if “everything is okay”

Treatment

Help for OCD is available. The evidence-based treatment, Exposure and Response Prevention (ERP), is a form of Cognitive Behavioral Therapy (CBT). ERP involves slowly confronting the anxiety-inducing situations or thoughts, and fighting impulses to yield to compulsive behavior. Psychoeducation on OCD and family support can help to speed up recovery. Treatment may be an initial source of anxiety. However, symptoms of OCD can be relieved with the help of a supportive, skilled therapist. Most individuals with OCD who receive proper treatment are relieved of symptoms and gain/regain the ability to function normally.

Questions to ask a mental health provider

The International OCD Foundation has a directory of mental health providers who are willing to treat OCD (https://iocdf.org/help/). You may use the questions that follow as a guide in searching for the right provider.

Make sure the mental health professional holds a current license. You should also look on the state licensing boards to see if there are any infractions against the license. Click here to: Verify the standing of a psychologist in Texas

Look for a provider who mentions cognitive behavior therapy (CBT) and Exposure and Response Prevention (ERP). If the provider is vague and does not explicitly state ERP, use caution.

Listen for therapists who say that they went to a CBT psychology graduate program or did a post-doctoral fellowship in CBT and ERP. It is a good sign if the provider is a member of the International OCD Foundation (OCDF), the Anxiety and Depression Association of America, or the Association for Behavioral and Cognitive Therapies (ABCT). Also listen for therapists who say that they have attended specialized workshops or trainings on OCD.

It is a good sign if at least 25% of the practice focuses on anxiety and related disorders.

Treatment for pediatric clients involves specialized techniques and approaches. If you are seeking services for a minor (under age 18), look for a provider who has CBT and ERP training with young clients.

This should be an unconditional ‘Yes’.

If the provider is negative about medicine this may be a bad sign. While not for everyone, medicine can be a helpful component of OCD treatment.

It is often necessary to go out of the office to do effective Exposure and Response Prevention (ERP). Look for providers who conduct exposure work in real life environments such as the home and community.
Information adapted from IOCDF: https://iocdf.org/about-ocd/treatment/how-to-find-the-right-therapist/

If you are seeking treatment for OCD and your mental health provider is not in network with your insurance company you may be able to obtain a single case agreement. In effect, a single case agreement would enable your treatment to be covered on an in-network basis, not out-of-network. There is a shortage of qualified mental health providers who are trained in exposure response prevention for OCD. Your insurance company is responsible for providing you with adequate evidence-based treatment. Dr. Fred Penzel wrote an informative article on how to advocate for your insurance benefits and Dr. Racine can also assist you with this process. Click here to read the steps to follow when seeking a single case agreement for OCD treatment: How to advocate for my insurance benefits

 

If you are unsure of whether you or a loved one may benefit from therapy, contact Dr. Racine for a free consultation.