perfectionism and - Obsessive-Compulsive Foundation

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6/14/13 FAMILY ACCOMMODATION & MAINTENANCE OF OCD Family members generally accommodate in order to avoid conflict and maintain peace. Accommodations only serve to reinforce the fear and the maintenance of the vicious anxiety cycle. Family members may be uncertain whether the repetitive rituals and persistent reassurance seekings are part of the symptommology or only demands for attention and control. It is important for family members to learn how to be supportive without giving into or enabling the OCD. The family structure and support system significantly impact the prognosis and outcome of OCD treatment. BEHAVIOR THERAPY GUIDELINES You cannot control your thoughts. You cannot control your feelings. You can control your behaviors. As you change your behaviors, your thoughts and feelings will also change. TREATMENTS THAT WORK Evidence-based treatments for OCD and other anxiety disorders are short-term and very effective. Psychoeducation – Reduces misattribution of psychophysiological symptoms. Cognitive-Behavioral Treatment (CBT): Learning to deal with fears by modifying the ways we think and behave. Cognitive Restructuring – Maintains changes in belief system. Rational Emotive Behavior Therapy (REBT) – Corrects faulty belief system and over-appraisal of danger. Acceptance & Commitment Therapy (ACT) – Addresses acceptance of uncertainty and letting go of control. Mindfulness Training – Increases awareness of physiological sensations to enhance emotional processing during exposures. TREATMENTS THAT WORK (CONT) Behavior Therapy: Behaving in ways to confront fears and reduce unnecessary fight-or-flight triggers. Prolonged Exposures – Confronts feared situations to change belief system of danger and ability to endure fight-or-flight discomforts. Response Prevention – Resists compulsive or safety behaviors and avoidances that only reinforce the anxiety cycle. Family Therapy: Reduces conflict, decreases unhealthy accommodations, and focuses on effective solutions. Parent Training: Provides support, improves communication skills, and educates methods to decrease anxiety. -125- 2
6/14/13 QUALIFICATIONS Treatment Orientation Behavior Therapy – ERP Cognitive Therapy Family Systems Therapy × Insight-Oriented Therapy – i.e., “Talk Therapy” Specialized Training Type of training – short-term vs. long-term Number of years’ experience with ERP Training from expert clinician Known specialist – locally or nationally Previous Successful Cases Number of successful treatments. Length of treatment. WHO NOT TO GO TO Professional Organizers w/o Hoarding specialist. Pure CBT ERP Concrete & Tangible STYLE OF TREATMENT Measures symptoms, improvements, etc. Looks for triggers & consequences Goal-oriented Always assigns HW Integrative Therapy More flexible Doesn’t adhere to measurements Assigns HW on occasion Integrates insight processing Useful for certain personality traits UNDERSTANDING INSURANCE BENEFITS The Basics: HMO vs PPO SATURDAY Life Coaches. Practitioners only reading books to learn to help you. Strictly insight oriented “talk” therapists. Practitioners with no training in ERP. Practitioners with no previous successful cases or expert consultations. Anyone you’ve seen for more than 6 sessions w/o experiencing relief. Advantages/Disadvantages Out of Network/In Network Provider Member Eligibility At THEIR rate! Single Case Authorization Disclosure of Allowable Reimbursement /Payment Determination Request Certification Process -126- 3
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IMAGINE THAT!: A SCRIPTING WORK- SH
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Themes and Variations - Theoretical
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Themes and Variations - Theoretical
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6/14/13 • Subjects (N = 20) with
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The Social Experiment 6/14/13 The
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6/14/13 How Do We Treat Social
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6/14/13 Exposure therapy is: A
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6/14/13 Detailed Inves5ga5on of
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6/14/13 Why Imaginal Exposure
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6/14/13! Common obsessions, continu
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6/14/13! 1# This circuit is called
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6/14/13! -33- 6!
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6/14/13! People with OCD experience
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6/14/13! 1a. Behavior Therapy! •
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ERP Exposed OCD Cycle Obsessions Re
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OCD Definition: OCD Cycle COMPULSIO
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Somatic Obsessions Miscellaneous Ob
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Exposure and Response Prevention -
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Strategic Model of Cognitive Treatm
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Segment 3 Every step of the way, ch
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You also have to tolerate anxiety
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Segment 9 Segment 10 Habituation re
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Get rapport (and get it again) Get
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6/14/13 Example #2: “Dave”
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6/14/13 Talking about Accommoda@o
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6/14/13 Making Decisions about A
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6/14/13 Dealing with Arguments
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Ask an Attorney - What Are My Right
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What is a major life activity Basic
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What is Reasonable Accommodation Mo
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Family and M edical L A eave ct IOC
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THE SPENCER LAW FIRM 2727 Camino de
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Page 90 and 91: Rewards Fear Stimulus CBT Model of
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Page 100 and 101: Fear of loss of impulse control ERP
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Page 116 and 117: The BDD Challenge 6/14/13 The BDD C
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Page 122 and 123: 6/14/13 COGNITIVE THERAPY CONT. IDE
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6/14/13 Jenny Jenny • Referred
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6/14/13 Appraisals of intrusions
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6/14/13 Bill • His intrusive
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6/14/13 Response Prevenaon • D
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6/14/13 Study Comparing Individual
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6/14/13 Exclusionary Criteria Struc
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6/14/13 Contact Information The OCD
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6/14/13 Acceptance vs. Change Chan
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6/14/13 Positive Reacting Styles P
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6/14/13 What is P-N-P What is P-N-
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People and Places - Emotional Conta
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6/14/13 CASE EXAMPLE • 67 year
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6/14/13 THE ROLE OF BETRAYAL
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6/14/13 THE ROLE OF ACCEPTANCE
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Challenging Kids Challenged Adults
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Regulatory Disorders Challenging Ki
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Tips for Non-OCD Anxiety Disorders
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Sleep Problems Tips for Sleep Probl
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EXECUTIVE FUNCTION “He is such a
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Write It or Regret It! CL UE Tips f
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Slow Processing Speed (Sluggish Cog
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Tips for Handwriting • Reduce cop
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Curiosity vs Judgment! © Sheryl K.
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Prepare the child for the path….
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How Can the Whole Family Fight OCD
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Task Description & Reminder of spec
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Using Scaffolding Steps in Unplanne
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6/14/13 Examples of Behavioral
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Assessment and Treatment of Postpar
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Cognitive-Behavioral Strategies in
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6/14/13 iCompulsions (OCD) or Cyber
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6/14/13 Similarities Between HC and
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6/14/13 Sample Exposures For Health
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6/14/13 The Effect of Attention (Ta
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6/14/13 Treatment • Stop all comp
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So You Expect Them to Leave Home So
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Daniel G. Pruitt, Jr., PCC, SCAC In
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NEEDED TRANSITION SKILLS: • Time
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Memory Functioning CL UE Short-Term
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Taking Medications Exercise! •Und
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Washer and Dryer TRANSITION SKILLS:
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TRANSITION SKILLS: Ready ! Money Ma
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TRANSITION SKILLS: • Tell them wh
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TRANSITION SKILLS: This Isn’t It!
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Tigers, Too Tigers, Too: Supplement
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WHEN REASSURANCE IS HARMFUL By Paul
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APOSTOLIC CHRISTIAN Counseling and
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