perfectionism and - Obsessive-Compulsive Foundation

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OCD Taboos - Strategic Responses to Sexual and Violent Intrusions 6/14/13 OCD TABOOS: Strategic Responses to sexual and violent intrusions Sco@ Blair-‐West MD Christopher Mogan PhD Throstur Bjorgvinsson PhD ABPP C.Alec Pollard PhD Case 1: Mother with intrusive thoughts of harming her daughter Sco8 Blair-‐West Director, The Melbourne Clinic InpaCent OCD Program, Australia IOCDF CONGRESS ATLANTA, GA 2013 Case -‐ Jenny Jenny SATURDAY • 43 year old woman, lives with husband and 6 year old daughter in Melbourne suburb, previously worked as teacher • Husband -‐ trainee surgeon, married 2005 • Moved from Brisbane to Melbourne, Jan 2012 • First seen by Clinical psychologist, June 2012 • Seen by me Sept 2012 • OCD symptoms from age 10 – sporadic intrusive thoughts that teachers were a@racted to her • Age 15 – thoughts in love with school friend’s mother, “what if I was a@racted” • 15-‐17 – ongoing thoughts, poor academic performance • Completed school, worked for 7 years as bank teller, sudden onset of intrusive thoughts of harming person si`ng in front of her on train, age 21, during this ame • Rapid generalizaaon harm to family and others – highly anxious, nightly prayers, religious rituals, harm self to keep contact with partner, requests for reassurance 3 4 -192- 1
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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 5 -13-
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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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Can’t - vs. -Won’t • If you s
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Rewards Fear Stimulus CBT Model of
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My Child-Brother-Sister Has OCD But
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I’m Afraid I’m Really Gonna Do
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Roger is a 52 year old widowed dent
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Fear of loss of impulse control: B:
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Fear of loss of impulse control ERP
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Sandra Practices walking with delay
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6/14/13 Defining the Problem- Raci
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6/14/13 Time for ERP Separation A
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Manipulating Language to Improve Pa
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6/24/13 SHIFT LANGUAGE TO PROMOTE H
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6/24/13 LABEL ANXIETY AND OCD Agai
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The BDD Challenge 6/14/13 The BDD C
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6/14/13 WHICH BODY PARTS ASSOCIATED
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6/14/13 WHAT DOESN’T APPEAR TO WO
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6/14/13 COGNITIVE THERAPY CONT. IDE
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6/14/13 ERP HIERARCHY #1 BDD ISSUE:
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6/14/13 IN CLOSING EDUCATION TREA
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6/14/13 FAMILY ACCOMMODATION & MAIN
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6/14/13 HMO HMO = Health Maintenan
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6/14/13 RECOGNIZE THE SIGNS OF OCD
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6/14/13 COLLABORATING WITH SCHOOLS
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Conceptualizing and Treating Hoardi
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6/24/13 DSM-‐5 criteria for
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6/24/13 Family Burden • Growin
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6/24/13 Biological vulnerability
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Page 146 and 147: 6/24/13 Mo8va8on and Ambivalence
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Page 150 and 151: 6/24/13 Behavioral Experiment: C
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Page 154 and 155: Perfecting Perfectionism Perfecting
Page 156 and 157: Types of Perfectionism Being th
Page 158 and 159: Healthy Perfectionism In general
Page 160 and 161: The cost of perfectionism • T
Page 162 and 163: Let’s Focus on Two Problemati
Page 164 and 165: • Are we there yet • The r
Page 166 and 167: Addressing Relapse in CBT for OCD 6
Page 168 and 169: 6/14/13 Lisa’s Exposure Hierar
Page 170 and 171: 6/14/13 Is Performance During E
Page 172 and 173: 6/14/13 Frame ERP to Mismatch
Page 174 and 175: 6/14/13 Implica:ons for Psychoed
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Page 196 and 197: 6/14/13 Jenny Jenny • Referred
Page 198 and 199: 6/14/13 Appraisals of intrusions
Page 200 and 201: 6/14/13 Bill • His intrusive
Page 202 and 203: 6/14/13 Response Prevenaon • D
Page 204 and 205: 6/14/13 Study Comparing Individual
Page 206 and 207: 6/14/13 Exclusionary Criteria Struc
Page 208 and 209: 6/14/13 Contact Information The OCD
Page 210 and 211: 6/14/13 Acceptance vs. Change Chan
Page 212 and 213: 6/14/13 Positive Reacting Styles P
Page 214 and 215: 6/14/13 What is P-N-P What is P-N-
Page 216 and 217: People and Places - Emotional Conta
Page 218 and 219: 6/14/13 CASE EXAMPLE • 67 year
Page 220 and 221: 6/14/13 THE ROLE OF BETRAYAL
Page 222 and 223: 6/14/13 THE ROLE OF ACCEPTANCE
Page 224 and 225: Challenging Kids Challenged Adults
Page 226 and 227: Regulatory Disorders Challenging Ki
Page 228 and 229: Tips for Non-OCD Anxiety Disorders
Page 230 and 231: Sleep Problems Tips for Sleep Probl
Page 232 and 233: EXECUTIVE FUNCTION “He is such a
Page 234 and 235: Write It or Regret It! CL UE Tips f
Page 236 and 237: Slow Processing Speed (Sluggish Cog
Page 238 and 239: Tips for Handwriting • Reduce cop
Page 240 and 241: Curiosity vs Judgment! © Sheryl K.
Page 242 and 243: 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 C = Increased Fear and Doub
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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 Health-Related OCD Case Exa
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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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