Detailed Program Description - Obsessive Compulsive Foundation

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the psychopharmacological treatment of children and adolescents with anxiety or mood disorders. In this capacity he supervises the psychopharmacological treatment of pediatric OCD in both inpatient and outpatient settings, often working in direct collaboration with the UF OCD Program when medication is needed in combination with ERP treatment. • In addition, the Division of Medical Psychology has interns and postdoctoral associates who are trained in the areas of CBT-ERP and have received specialty training in the treatment of children or adults with OCD, anxiety disorders, depressive disorders. 3. Is this program devoted entirely to treating individuals with OCD or will other OCD spectrum disorders or anxiety disorders also be addressed • The UF OCD Program therapists also provide the leading treatments to address OCD spectrum disorders and other anxiety disorders. In general, CBT-ERP would be used for other anxiety disorders and Habit Reversal Training would be implemented for OCD spectrum disorders. Additionally, a wide range of comorbid conditions can be addressed during OCD treatment. 4. Please describe the core treatment components of your program (e.g., use of medication, ERP, group therapy, etc.). • During the first appointment, a comprehensive intake is completed. For those with OCD, an assessment of symptom severity is conducted using the Children’s Yale Brown Obsessive Compulsive Scale or the Yale Brown Obsessive Compulsive Scale at intake and various points throughout treatment so that we can track improvement in various OCD symptom domains. For those where the use of CBT-ERP is the best line of treatment, pyschoeducation is provided to the patient about OCD and why CBT-ERP is the most effective method to treat it. A fear hierarchy will be generated and a discussion will occur about how the patient and the treatment team will work in a collaborative manner, at the pace of the patient, to do exercises that prove OCD wrong. CBT-ERP will then occur until symptom severity is reduced, at which point a discussion of relapse prevention will occur at the end of treatment. We will address other psychological symptoms that we know interfere with treatment and, in this vein, we are always adjusting CBT- ERP treatment to incorporate other treatment techniques to improve treatment response (e.g., Motivational Interviewing, Acceptance and Commitment Therapy) as needed. Patients may be referred to receive consultation with our psychiatry team regarding a medication consultation on an as needed/as requested basis. However this occurs in rare cases as the research from our and others clinics and our clinical experience support only using medication in combination with therapy in very specific cases. 5. Please describe the treatment planning process at your program. • After the intake, all treatment providers will meet with Dr. Geffken or Dr. McNamara to discuss the case and create the best individualized treatment plan. This is a collaborative process in which the family’s stated goals at intake are addressed. This plan will be conveyed to the patient and their caregivers or family members, as it is important for everyone in the home to understand OCD or OCD related disorders so that appropriate support can be provided and so family members understand how to not accommodate to the patient’s symptoms. 6. If someone has a co-morbid condition, can he or she participate in your program Will there be treatment for the co-morbid condition If so, can you give an example
• Those with any co-morbid conditions are eligible to receive treatment. Treatment priority will be determined based off what the patient ranks as the most distressing symptoms, what conditions may interfere with the treatment of others, and time available for treatment. This decision is made after extensive discussion with the patient and their family. In most cases, treatment can simultaneously target multiple symptoms. Our providers have stated interests in treating comorbid anxiety disorders, eating disorders, sleep disorders, school refusal, medical regimen adherence, bed wetting, and Autism Spectrum Disorders. 7. Are parents, family members, friends, teachers, etc. included in the treatment If yes, please describe how. • With OCD treatment, as with many mental health conditions, family members can play a seminal role in shaping and maintaining treatment outcomes. Thus, we offer Family-Based CBT-ERP when feasible and appropriate which directly includes family members in the treatment of OCD. Research shows that involving family members increases familial understanding of patient’s symptoms and teaches them how to balance supporting the patient versus doing behaviors that actually maintain the patient’s symptoms and increase stress on the family. In short, involving individuals who interact with the patient frequently outside of the therapy room often improves treatment effectiveness. However, familial involvement is up to the patient and in some cases is not appropriate. In addition, key stakeholders such as teachers may be provided with consultation to help increase sustainability and adherence to the treatment protocol maintenance in a wide variety of settings. 8. How often do patients in the program meet with staff individually How long are these individual sessions • Decisions regarding the frequency of how often patients meet with staff members is determined following the intake. In general, patients receiving treatment attend sessions lasting approximately 60 to 90 minutes. Treatment is offered on a monthly, weekly or daily basis. 9. Is there a set time period for a patient’s treatment in the program What is the overall time commitment to the program (for example, attend daily for three weeks) How much flexibility is there in extending someone’s stay if needed • The frequency and intensity of sessions is determined on a case by case basis. Generally, patients receive treatment on a weekly basis for approximately 15 sessions lasting approximately 60-90 minutes. Those who participate in the intensive treatment program receive treatment on a daily basis for 15 sessions lasting approximately 60-90 minutes. There is flexibility in booster sessions after these 15 sessions, but based off research and clinical experience we generally encourage patients to at least try a period of time away from treatment (e.g., 1-3 months) at this point to practice treatment skills before returning to address any remaining symptoms. 10. Is there a homework or “self directed” component to the treatment • Patients are asked to complete daily homework as part of their treatment in order to facilitate the treatment, provide opportunities to practice strategies that they have learned in treatment outside of the office, as well as to help extend treatment gains to the natural environment (e.g., school, home). 11. Please describe the relapse prevention strategies you use in your program.
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Detailed Program Description - Obsessive Compulsive Foundation

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