Effective Treatment for Obsessive-Compulsive Disorder
Exposure and Ritual Prevention
Cognitive behavioral therapy (CBT)is a form of psychotherapy that treats problems and improves quality of life by modifying behaviors, emotions, and thoughts. CBT focuses on solutions, encouraging individuals to challenge distorted thoughts (“cognitive therapy”) and change problematic patterns of behavior (“behavioral therapy”).
Currently, exposure and ritual/response prevention (EX/RP) is the most effective type of CBT treatment for obsessive-compulsive disorder (OCD). In fact, EX/RP is the most effective treatment period — even more effective than medication — which is why we use it at the Behavioral Wellness Clinic. Exposure is the cornerstone of EX/RP treatment and has been scientifically shown to reduce obsessions and related distress in multiple research studies and randomized clinical trials. This technique involves gradual, repeated, and prolonged confrontation with situations that cause anxiety until the anxiety fades away.
The ritual or response prevention component involves learning how to stop compulsions or rituals. This is important because people with OCD often think that the compulsions prevent the occurrence of a feared outcome. Only by stopping the compulsions do clients learn that rituals do not protect them from their obsessional concerns.
OCD Treatment Program
The OCD treatment program includes psychoeducation, treatment planning, exposure and ritual prevention activities (EX/RP also called ERP), relapse prevention training, and home visits as needed. The program typically includes the following components, as well as weekly group therapy:
- 1 Comprehensive Evaluation: This is a 2-3 hour session where you will receive an in-depth clinical interview to review all of your symptoms and provide a diagnosis. This can be done over two sessions for local clients.
- 2 Treatment Planning Sessions: During these sessions we review your OCD symptoms in detail and develop a hierarchy to guide the treatment process.
- 15 Treatment Sessions: These sessions are focused on activities to reduce obsessions and compulsions; you will do an exposure exercise in session that will be assigned for practice at home.
- 2 Family Sessions (if applicable): If your family has been a part of your OCD, family sessions will be administered to help household members understand the disorder and learn what they can do to help.
- 2 Follow-up Sessions: These will take place 3-4 weeks after treatment to address any lingering difficulties and ensure maintenance of gains.
If your OCD is severe or you have other mental health conditions as well, you may need ongoing follow-up after the treatment program. If you are coming from out of the area, we will help you locate a local provider for your follow-up care, if you don't already have one. Alternately, we can do follow-up sessions online. Follow-up for severe cases is typically weekly for 3-6 months.
Treatment is usually delivered in two 60-90 minute (double) sessions per week. For people coming from outside of the New England area, intensive treatment is offered, which is generally daily 90-120 minute sessions over a 7 day period (including weekends), followed by 10 onine sessions. Family sessions are 45 minutes. Follow-up sessions are 30-45 minutes. Also you should anticipate 1-2 hours of homework each day. Most sessions are in person, but phone or videoconference may be used on an as-needed basis.
Effectiveness of Treatment
There is no cure for OCD, but clients can generally expect great reductions in distress and a return to normal behaviors. Clients who attend sessions and do the homework will typically make great improvements, and those who do not follow the program will experience less improvement. For most people, this type of treatment is more effective than medication for OCD. However, some people will require both medication and the treatment program for maximum results.
Cost of Treatment
Call us or send email to inquire about costs, and be sure to include your location. Insurance is not accepted, but if your plan offers out-of-network benefits, you can usually get some reimbursement. You should call your insurer to make sure they will cover out-of-network providers. Our office is also glad to contact them to help figure out how much of the cost you can likely recoup. We can assist you with insurance paperwork.
If your insurance won't reimburse for a 90-minute session, we can do 60-minute sessions instead, but then we will need more sessions than 17, so the treatment period will be longer.
Daily treatment over a 2 week period is offered for those coming from out of town. There are several hotels nearby and travel around the area is not difficult. Learn more about our OCD intensive outpatient treatment program (IOP) at the New England OCD Institute.