perfectionism and - Obsessive-Compulsive Foundation

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6/24/13 DSM-‐5 criteria for HD Specify if: • Good or fair insight: Recognizes that hoarding-related beliefs and behaviors (pertaining to difficulty discarding items, cluVer, or excessive acquisi8on) are problema8c. • Poor insight: Mostly convinced that hoarding-related beliefs and behaviors are not problema8c despite evidence to the contrary. • Absent insight (Delusional beliefs about hoarding): Completely convinced that hoarding-related beliefs and behaviors are not problema8c despite evidence to the contrary. Prevalence of Hoarding • Samuels et al. (2008) = 5% in US (adjusted) • Iervolini et al. (2010) = 2.3% (UK) • Mueller et al. (2009) = 4.6% (Germany) • Timpano et al. (2011) = 5.8% (Germany) OCD prevalence = 1-‐2.5% COMORBID DISORDERS IN HD 30 Age of Onset in Hoarding 60% DX 25 26.6 24.1 50% 40% 30% 20% 10% 0% MDD GAD SAD ADHD OCD PTSD DX % Repor'ng Onset 20 15 10 5 0 13.8 10.8 8.1 3.7 4.8 4.4 2.5 0.7 0.1 0.1 0.1 5 10 15 20 25 30 35 40 45 50 55 60 65+ Tolin et al. (2010) -135- 3
6/24/13 % of Respondents with Moderate to Severe Hoarding Hoarding in Children 100%! 90%! 80%! 70%! 60%! 50%! • Overlapping with ADHD • Reac8ons to touching/moving objects • LiVle insight 40%! 30%! 20%! 10%! 0%! 0-5 yrs! 6-10 11-15 16-20 21-25 26-30 31-35 36-40 41-45 46-50 51-55 56-60 61-65 66-70 yrs! yrs! yrs! yrs! yrs! yrs! yrs! yrs! yrs! yrs! yrs! yrs! yrs! Tolin DF, et al. Depress Anxiety. 2010. Hoarding in Elders • Abnormal personifica8on • Essen8alism Hazards of Hoarding SATURDAY • 15 – 30% of elderly people in private and public housing had hoarding problems • Medical problems – Medica8on and dietary mismanagement can worsen medical condi8ons – Risk of falling • Impairment in ac8vi8es of daily living – Loss of important items, tracking finances • Housing problems – Premature reloca8on to senior housing or evic8on – Risk of losing independent living status • Social isola8on • Poor Sanita8on • Mobility Hazard • Blocked Exits • Community Cost • Homelessness • Fire Hazard Ayers et al., 2012; Diefenbach et al., 2012; Kim et al., 2001; Marx & Cohen-‐ Mansfield, 2003; Whimield et al., 2011 Frost et al. (2000) -136- 4
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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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Importantly, the ADA requires cover
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Some possible reasonable accommodat
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THE SPENCER LAW FIRM 2727 Camino de
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insurance, sick leave, education be
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Protection and Advocacy The Protect
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Page 100 and 101: Fear of loss of impulse control ERP
Page 102 and 103: Sandra Practices walking with delay
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Page 106 and 107: 6/14/13 Defining the Problem- Raci
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Page 112 and 113: 6/24/13 SHIFT LANGUAGE TO PROMOTE H
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Page 116 and 117: The BDD Challenge 6/14/13 The BDD C
Page 118 and 119: 6/14/13 WHICH BODY PARTS ASSOCIATED
Page 120 and 121: 6/14/13 WHAT DOESN’T APPEAR TO WO
Page 122 and 123: 6/14/13 COGNITIVE THERAPY CONT. IDE
Page 124 and 125: 6/14/13 ERP HIERARCHY #1 BDD ISSUE:
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Page 128 and 129: 6/14/13 FAMILY ACCOMMODATION & MAIN
Page 130 and 131: 6/14/13 HMO HMO = Health Maintenan
Page 132 and 133: 6/14/13 RECOGNIZE THE SIGNS OF OCD
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Page 142 and 143: 6/24/13 Biological vulnerability
Page 144 and 145: 6/24/13 • Depression • Self-
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Page 158 and 159: Healthy Perfectionism In general
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Page 166 and 167: Addressing Relapse in CBT for OCD 6
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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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6/14/13 iCompulsions (OCD) or Cyber
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6/14/13 Similarities Between HC and
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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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