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Behavioral Wellness Clinic

MENTAL HEALTH & COUNSELING SERVICES IN CONNECTICUT AND ONLINE


Effective Treatment for Obsessive-Compulsive Disorder

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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

Treatment Overview

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 Format

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.

Intensive Program

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.

Don't Be Fooled

Not all treatments for OCD are equal, and some don't work at all...

It can be hard for the average consumer to know what therapy is best for OCD. We have been troubled by the number of unscrupulous charlatans promoting expensive snake oil to suffering people in Connecticut. Beware of quacks and frauds offering treatments for OCD that don't work.

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Here are a few of these unproven OCD treatments :

Neurofeedback

Individuals with OCD are especially prone to overthinking or repetitive thinking, which results in increased activity in certain parts of the brain. As a result, some clinicians have theorized that neurofeedback can reduce these overactive brain waves to retrain the brain and thereby reduce obsessions and compulsions. Don’t be fooled. This is simply nonsense.

Biofeedback

Biofeedback is a mind-body technique where individuals learn how to modify their physiology to improve physical, mental, emotional and spiritual health. Patients learn to voluntarily control what were once thought to be involuntary body processes. Although helpful for some conditions like female incontinence and ADHD, there is no research showing it works as an independent treatment for OCD.

Other Useless Treatments

Traditional talk therapy, supportive therapy, psychodynamic therapy, relaxation exercises, yoga, tapping, pulsed electromagnetic field therapy (PEMF), hypnosis, somatic therapy, play therapy, art therapy, and music therapy, are all useless as stand-alone treatments for OCD. However, these may improve overall well-being in other ways unrelated to OCD. Also, play or art therapy may be integrated into effective CBT therapies for children.

What Therapies work? CBT!

The only scientifically proven psychotherapies for OCD are a few specific cognitive behavioral therapies (CBT). These include exposure and ritual prevention (described above), cognitive therapy, and to a lesser degree, Acceptance and Commitment Therapy (ACT). Effective OCD requires a high level of expertise. Make sure your OCD provider has specialized training in the treatment of this disorder.

References

Rodriguez, C. I., Bloch, M., Sachs, R., & Williams, M. T. (2015, June). Practice Guidelines: Obsessive Compulsive Disorder. Anxiety and Depression Association of America.

Williams, M., Powers, M., & Foa, E. (2012). Obsessive-compulsive disorder, Chapter 16. In P. Sturmey & M. Hersen (Eds.), Handbook of Evidence-Based Practice in Clinical Psychology, Vol. 2 (pp. 313-335). Hoboken, NJ: John Wiley & Sons. ISBN-13: 978-0470335468.

BEHAVIORAL WELLNESS CLINIC

392 MERROW RD, SUITE E
TOLLAND, CT 06084
OFFICE: (860) 830-7838
FAX: (860) 454-0667

 
CLINICAL DIRECTOR: MONNICA WILLIAMS, PHD
OFFICE MANAGER: JASMINE FAIRFAX
BUSINESS MANAGER: MATTHEW JAHN

 
FRONT DESK PHONE HOURS
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Tu: 8:30 am - 4:30 pm [DZ]
We: 8:30 am - 4:30 pm [DZ]
Th: 8:30 pm - 4:30 pm [DZ]
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Sa: by appointment [ZJ]