perfectionism and - Obsessive-Compulsive Foundation

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6/14/13 Detailed Inves5ga5on of OCD Symptoms • “Func5onal (behavioral) analysis” ERP Treatment Program • Guided by the conceptual framework • Gather specific informa5on about the antecedents, behaviors, and consequences – External fear cues – Intrusive obsessional thoughts and beliefs – Feared consequences associated with cues and obsessions – Avoidance and rituals – Consequences of avoidance and rituals • Leads directly to the treatment plan Segng Up the Treatment Plan Sample Exposure Hierarchy • Generate list of situa5ons and thoughts for exposure – Realis5cally safe – Evoke obsessional distress and urges to ritualize • Pa5ent rates subjec5ve units of discomfort (SUDS) for each situa5on or thought • Collabora5ve effort in genera5ng exposure hierarchy – Start with s5muli of moderate difficulty – Highest items must be included • Generate a list of rituals to target • Public surfaces (doors, bubons) (48 SUDS) • Floors (60) • Garbage cans/dumpsters (60/65) • “Buggy” room (75) • Clothes from “buggy” dresser (80) • Bugs (90) • Home bathroom • Public bathroom -25- 4
6/14/13 Early Treatment Sessions • Begin with only moderately distressing s5muli and intrusions • Coaching and encouragement in abstaining from rituals • Trouble-‐shoo5ng and planning future exposure exercises together Moving Up the Hierarchy • Build on past successes from earlier sessions • Encourage pa5ent to choose from among equivalent s5muli for exposures • Note changes in impairment & decreased symptoms to highlight improvement FRIDAY Confron5ng the Greatest Fears Stylis5c Considera5ons • Encouragement and praise for efforts • Modeling • Discussion of acceptable vs. unacceptable risk • Repeated and prolonged exposure • Emphasis on learning to tolerate fear and uncertainty • Confront fears in mul5ple contexts • Therapist as coach and cheerleader • Therapist and pa5ent vs. OCD – not therapist vs. pa5ent + OCD • Focus on “choosing to be anxious” and “increasing risk tolerance” • Discourage reassurance-‐seeking or analyzing • Use of humor • Providing treatment outside of the office • It’s OK if anxiety doesn’t subside – fear tolera5on -26- 5
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Page 22 and 23: The Social Experiment 6/14/13 The
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Page 58 and 59: Get rapport (and get it again) Get
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Page 62 and 63: 6/14/13 Talking about Accommoda@o
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Page 68 and 69: Ask an Attorney - What Are My Right
Page 70 and 71: What is a major life activity Basic
Page 72 and 73: What is Reasonable Accommodation Mo
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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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