perfectionism and - Obsessive-Compulsive Foundation

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Strategic Model of Cognitive Treatment for OCD Reid Wilson, Ph.D. Anxiety Disorders Treatment Center 421 Bennett Orchard Trail Chapel Hill, NC 27516 [919] 942-0700 rrw@med.unc.edu www.anxieties.com 1 2 Segment 1 Look for any signs that they can dissociate from the content. Work that. • “In my mind…” – “What does that tell you” • “Naïve question: so why don’t you just not wash, since you know it’s in your mind” Flesh out & get rapport with their struggle Be curious & respectful • “Tell me how it’s hard to resist” Any attempts to change Any tricks Any control in some arenas 3 4 -47-
Segment 2 Personify & externalize OCD. When they are all better, they will have separated from the disorder. Why don’t we start treatment from that position • “What’s your OCD tell you is going to happen” • She immediately follows suit: “The main thing OCD tells me is…” 5 If they have made any gains, use them to challenge their OCD logic Move away from a continuum & toward a black or white, either/or scenario Continue with naïve curiosity • “If you believe it is about contamination, then why would relaxation help” 6 FRIDAY It’s “great news” if they have used any therapeutic strategy to dissociate from the content. This means we don’t have to add anything from outside of them. We simply have to embellish a resource within them. Embellish, reinforce actions that manifest belief that content is irrelevant. • Here she uses relaxation You have a perspective The problem is that the closer you get to the threat, the further away that perspective drifts [And that will be our goal: to find a way to maintain that perspective while facing threat. The work is moment-by-moment.] 7 8 -48-
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Page 22 and 23: The Social Experiment 6/14/13 The
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Page 26 and 27: 6/14/13 Exposure therapy is: A
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Page 30 and 31: 6/14/13 Why Imaginal Exposure
Page 32 and 33: 6/14/13! Common obsessions, continu
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Page 38 and 39: 6/14/13! People with OCD experience
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Page 42 and 43: ERP Exposed OCD Cycle Obsessions Re
Page 44 and 45: OCD Definition: OCD Cycle COMPULSIO
Page 46 and 47: Somatic Obsessions Miscellaneous Ob
Page 48 and 49: Exposure and Response Prevention -
Page 52 and 53: Segment 3 Every step of the way, ch
Page 54 and 55: You also have to tolerate anxiety
Page 56 and 57: Segment 9 Segment 10 Habituation re
Page 58 and 59: Get rapport (and get it again) Get
Page 60 and 61: 6/14/13 Example #2: “Dave”
Page 62 and 63: 6/14/13 Talking about Accommoda@o
Page 64 and 65: 6/14/13 Making Decisions about A
Page 66 and 67: 6/14/13 Dealing with Arguments
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
Page 74 and 75: Family and M edical L A eave ct IOC
Page 76 and 77: THE SPENCER LAW FIRM 2727 Camino de
Page 78 and 79: Importantly, the ADA requires cover
Page 80 and 81: Some possible reasonable accommodat
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Page 84 and 85: insurance, sick leave, education be
Page 86 and 87: Protection and Advocacy The Protect
Page 88 and 89: Can’t - vs. -Won’t • If you s
Page 90 and 91: Rewards Fear Stimulus CBT Model of
Page 92 and 93: My Child-Brother-Sister Has OCD But
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Page 96 and 97: Roger is a 52 year old widowed dent
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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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