perfectionism and - Obsessive-Compulsive Foundation

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The Social Experiment 6/14/13 The Social Experiment Take 2 IOCDF Conference 2013 -‐ Atlanta, Georgia Jason Spielman, Psy.D, Lindsay Stewart, Ph.D, Michelle Otelsberg, MFT, Ethan Smith • Plan for today... • Introductions Welcome! • Summary of the Research • Exposures • Discussion ABC’s of OCD • Diagnostic criteria for Obsessive-Compulsive Disorder • A. Either obsessions or compulsions: • Obsessions as deDined by (1), (2), (3) & (4): • 1. Recurrent & persistent thoughts, impulses, or images that are experienced, at some time during the disturbance, as intrusive & inappropriate & that cause marked anxiety or distress. • 2. Thoughts, impulses, or images are not simply excessive worries about real-‐life problems • 3. The person attempts to ignore or suppress such thoughts, impulses, or images, or to neutralize them w/ some other thought or action • 4. The person recognizes that the obsessional thoughts, impulses, or images are a product of his own mind • Compulsions as deDined by (1) & (2): • 1. Repetitive behaviors or mental acts the person feels driven to perform in response to an obsession, or according to rules that must be applied rigidly 2. The behaviors or mental acts are aimed at preventing or reducing distress or preventing some dreaded event or situation; however, these behaviors or mental acts either are not connected in a realistic way w/ what they are designed to neutralize or prevent or are clearly excessive • B. At some point during, the person recognizes the obsessions or compulsions are excessive or unreasonable. Note: This does not apply to children. • C. Obsessions or compulsions cause marked distress, are time consuming (take >1 hr a day), or signiDicantly interfere w/ the person's normal routine, occupational (or academic) functioning, or usual social activities or relationships. ABC’s of OCD • What are some common obsessions • How about common compulsions -19- 1
6/14/13 OCD & Social Functioning • By deDinition, OCD can cause impairment in important areas of functioning, with social functioning often being affected. • What are some ways OCD affects you socially • Not being able to focus during conversation with friends because your counting in your head... • Not being able to join friends or family for meals due to fears of contamination... • Not being able to play sports because of fears of contact with sweaty or germy people... • The list goes on.... Social Anxiety Disorder • OCD is often “co-‐morbid” with other problems. This means it tends to co-‐occur with other things, like depression, tic disorders, or panic. • Torresan & colleagues (2013) • Studied 858 men & woman OCD patients; assessed for lifetime prevalence of other Axis I Disorders using the YBOCS & SCID • 90% had a secondary diagnosis • 72% had a Mood Disorder • 20% had Panic Disorder and/or Agoraphobia • 34% had Generalized Anxiety Disorder • 36% had Social Anxiety Disorder • Brown & colleagues (2001) • Studied 1127 patients presenting for treatment of anxiety disorders; used ADIS-‐IV • 79% of the patients with OCD had at least one additional diagnosis at the time of the evaluation • OCD (along with Social Anxiety and PTSD) was associated with signiDicant risk of Depression. FRIDAY What is Social Anxiety Disorder (or Social Phobia) • Diagnostic Criteria for Social Anxiety Disorder • A. A marked & persistent fear of > 1 social or performance situations in which the person is exposed to unfamiliar people or to possible scrutiny by others. The individual fears that he will act in a way (or show anxiety symptoms) that will be humiliating or embarrassing. • B. Exposure to the feared social situation almost invariably provokes anxiety, which may be situationally bound • C. The person recognizes that the fear is excessive or unreasonable. Note: In children, this feature may be absent. • D. The feared social or performance situations are avoided or else are endured w/ intense anxiety or distress. • E. The avoidance, anxious anticipation, or distress in the feared social or performance situation(s) interferes signiDicantly w/ the person's normal routine, occupational (academic) functioning, or social activities or relationships, or there is marked distress about having the phobia. • F. In individuals under age 18 years, the duration is at least 6 months. How Do We Treat OCD • ERP • Anxiety Curve • SUDS • ACT / Radical Faith (Ethan) -20- 2
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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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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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Manipulating Language to Improve Pa
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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 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 Behavioral Experiment: C
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6/24/13 Treatment Responders (%)
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Perfecting Perfectionism Perfecting
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Types of Perfectionism Being th
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Healthy Perfectionism In general
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The cost of perfectionism • T
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Let’s Focus on Two Problemati
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Addressing Relapse in CBT for OCD 6
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6/14/13 Jenny Jenny • Referred
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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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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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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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