perfectionism and - Obsessive-Compulsive Foundation

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6/14/13 Exposure therapy is: A set of techniques designed to help pa5ents confront situa5ons that elicit excessive or inappropriate fear and anxiety. The Treatment of Fear • Exposure to fear-elici5ng s5muli or situa5ons • Resis5ng ritualis5c behaviors • Anxiety increases ini5ally, followed by habitua5on Fear level 100 90 80 70 60 50 40 30 20 10 0 Time Exposure • OCD symptoms are reduced when the person comes to believe his/her fears are unfounded and acts accordingly • Simply talking about probabili5es of danger is not as convincing as direct evidence from experience – Pa5ents need to directly confront their fears to truly master them • Exposure is a behavioral interven5on, but it changes beliefs about external cues, obsessional thoughts, and the experience of anxiety and doubt What Happens During Exposure • We don’t “unlearn” a fear, we acquire new learning that competes with previous learning • The current context determines our percep5on of danger or safety • The central task in ERP is to create context-independent learned safety -23- 2
6/14/13 Basics of Exposure • ERP is a set of “experiments” that test the accuracy of anxious predic5ons, such as: – Obsessions are signs of disastrous consequences – I can’t tolerate anxiety/uncertainty • Pa5ents prac5ce confron5ng their fears in a planned and systema5c manner (oaen using a hierarchy) • Exposures are prac5ced without the use of compulsive rituals (i.e., response preven5on) Types of Exposure used for OCD • In vivo exposure -‐ confron5ng feared s5muli in the environment • Imaginal exposure -‐ confron5ng feared mental s5muli such as thoughts, images, impulses, worries, and memories FRIDAY Response Preven5on Response Preven5on (cont’d) • Ra5onale: weaken the pabern of using rituals to control anxiety – Learn that rituals are unnecessary • Goal is to refrain from all ritualizing and avoidance – May have to start with par5al RP • Washers: 1 daily 10-‐minute shower otherwise no contact with water • “Effortless” rituals: do them incorrectly • Coun5ng: count to the wrong number • If a ritual is performed: re-‐expose • Self-‐monitoring of rituals – Situa5on or thought that evoked the ritual – Anxiety level – Time spent ritualizing • Viola5on of RP means we have to work harder on that par5cular area -24- 3
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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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6/24/13 • Depression • Self-
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6/24/13 Mo8va8on and Ambivalence
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6/24/13 Skills Training: Objec8ve
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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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• Are we there yet • The r
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Addressing Relapse in CBT for OCD 6
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6/14/13 Lisa’s Exposure Hierar
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6/14/13 Is Performance During E
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6/14/13 Frame ERP to Mismatch
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6/14/13 Implica:ons for Psychoed
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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 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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