perfectionism and - Obsessive-Compulsive Foundation

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6/14/13 C = Increased Fear and Doubt D = Action to Neutralize Anxiety D = Action or avoidance to reduce fear and uncertainty A = Increased likelihood of the next activating somatic or health-related event Exposure & Response Prevention Cognitive-Behavioral Treatments -257- 7
6/14/13 Habituation Naturally occurring reduction in anxiety resulting from prolonged exposure to an anxiety provoking thoughts, feelings, impulses, as well as the situations in which they occur. “Nervous system boredom” “You can’t be bored and scared at the same time” (Fred Penzel, Ph.D.) Steps in ERP for Health-Related OCD Typical Exposure Hierarchy For Cancer Obsession (Sample) SUDS (0=none 100=extreme) Reading medical article on cancer mortality 40 Touching photos of actual cancer tumors 50 Sitting in waiting area of hospital cancer unit 60 Touching sign “Chemotherapy Clinic” with 70 gloves Touching sign “Chemotherapy Clinic” without 80 gloves Shaking hands with cancer patient with gloves 90 on Shaking hands with cancer patient without 100 gloves on SUNDAY -258- 8
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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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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
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….
Page 244 and 245: How Can the Whole Family Fight OCD
Page 246 and 247: Task Description & Reminder of spec
Page 248 and 249: Using Scaffolding Steps in Unplanne
Page 250 and 251: 6/14/13 Examples of Behavioral
Page 252 and 253: Assessment and Treatment of Postpar
Page 254 and 255: Cognitive-Behavioral Strategies in
Page 256 and 257: 6/14/13 iCompulsions (OCD) or Cyber
Page 258 and 259: 6/14/13 Similarities Between HC and
Page 262 and 263: 6/14/13 Sample Exposures For Health
Page 264 and 265: 6/14/13 The Effect of Attention (Ta
Page 266 and 267: 6/14/13 Health-Related OCD Case Exa
Page 268 and 269: 6/14/13 Treatment • Stop all comp
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Page 282 and 283: So You Expect Them to Leave Home So
Page 284 and 285: Daniel G. Pruitt, Jr., PCC, SCAC In
Page 286 and 287: NEEDED TRANSITION SKILLS: • Time
Page 288 and 289: Memory Functioning CL UE Short-Term
Page 290 and 291: Taking Medications Exercise! •Und
Page 292 and 293: Washer and Dryer TRANSITION SKILLS:
Page 294 and 295: TRANSITION SKILLS: Ready ! Money Ma
Page 296 and 297: TRANSITION SKILLS: • Tell them wh
Page 298 and 299: TRANSITION SKILLS: This Isn’t It!
Page 300 and 301: Tigers, Too Tigers, Too: Supplement
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Page 308 and 309: WHEN REASSURANCE IS HARMFUL By Paul
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APOSTOLIC CHRISTIAN Counseling and
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