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Breaking The Chains Psychological Treatment for OCD. < single image > 4.3cm x 5.5cm. Dr. Siobhan Kelly Psychologist Psychology Services KK Women ’ s & Children ’ s Hospital 25 th May 2013. Contents. Treatment guidelines for OCD. Evidence and rationale for CBT. How does CBT help?

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  1. Breaking The Chains Psychological Treatment for OCD < single image > 4.3cm x 5.5cm Dr. Siobhan Kelly PsychologistPsychology ServicesKK Women’s & Children’s Hospital 25th May 2013

  2. Contents Treatment guidelines for OCD. Evidence and rationale for CBT. How does CBT help? Treatment of OCD in Children & Adolescents. Barriers in Seeking Treatment. Getting treatment.

  3. Treatment Guidelines for OCD • Guidelines for the treatment of OCD recommend; • Cognitive Behavioural Therapy (CBT), which includes Exposure Response Prevention (ERP) for treating OCD. • Use of medication in combination with CBT. • Inclusion of psychoeducation and involvement of family members. 3

  4. Cognitive Behavioural Therpy Divider Title 1 4

  5. What’s Involved in Treatment? Assessment Making Sense of OCD.

  6. Rationale For CBT Trigger Touching a door handle Intrusive Thoughts/ Obsession “The door handle has germs” Appraisal of the thought “I am going to get sick, it’s going to be my fault if other people get sick too” Anxiety Compulsions Washing hands multiple times Avoidance/ Safety Behaviours Asking people to open doors 6

  7. Rationale of CBT 7

  8. What’s Involved in Treatment? • 3. Cognitive Therapy • Interpretation of the intrusive thought contributes to anxiety. • CT helps distance and manage anxiety by challenging these thoughts.

  9. What are the chances that if I touch the door handle I will get sick? • How many people have touched the door before & not gotten sick? • If people could get sick from touching the door handle, then why are more people not afraid of touching the door handle?

  10. What’s Involved in Treatment? • 3. Exposure and Response Prevention • Exposure- confronting the images, objects & situations that make someone anxious. • Response Prevention- resisting urge to do the compulsive behaviour.

  11. What’s Involved in Treatment? • Initial increase in anxiety will be expected. • Usually ERP will be done in a graded/gradual manner.

  12. Family Involvement • OCD can affect the entire family & often cause stress to relationships. • Families often unintentionally help OCD behaviours through: • Participation in rituals and reassurance. • Assisting in avoidance. • Accommodating the OCD behaviours.

  13. OCD in Adolescent & Children • Evidence suggests that CBT is also effective in treating children & adolescents with OCD (Abramowitz, Whiteside & Deacon, 2005). • Treatment needs to be adjusted to be developmentally appropriate. • Family involvement is more critical.

  14. Taken from OCD-UK 14

  15. Common Barriers to Seeking Treatment • Lack of understanding/public awareness of OCD. • Embarrassment. • Fear of treatment. • Difficulties in assessing appropriate services. 15

  16. Where Can I Seek Help? • Adult • Local hospitals • Private hospitals • Private Clinical Psychologists

  17. Where Can I Seek Help? • Children • Child Guidance Clinic (CGC) • KKH – if child is already on regular follow-up with a Medical doctor. • REACH- referral made by school counsellor. • Private hospital • Private Clinical Psychologist.

  18. Questions I Should Ask • What techniques do you use to treat OCD? • Do you use ERP to treat OCD? • What are your training and background in treating OCD? • What are your thoughts on medication?

  19. Online Resources • International OCD foundation • http://www.ocfoundation.org • OCD UK • http://ocduk.org/

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