Monday, June 29, 2015

OCD: Treatment via Support Groups

By Guest Blogger Beth McCreary, Ph.D.

Support Groups for OCD

I appreciate the opportunity to share some information on OCD and Support Groups.  I’ll first summarize some information on OCD and its treatments, then share the information about OCD Support Groups.

Obsessive compulsive disorder (OCD) affects approximately 1.2% of the population of the United States in any given year.  Those living with OCD experience intrusive thoughts, images, or urges that they find distressing and do not want to be having (“obsessions”), and from which they can sometimes gain temporary relief by engaging in overt or covert ritualized behaviors (“compulsions”).  However, engaging in compulsions can consume enormous time and energy, and, across the long term, actually perpetuates obsessive thoughts and associated anxiety.  The experience of OCD can range from frustrating and mildly interfering in quality of living to completely disabling.  OCD has strong genetic and other biological correlates, and tends to be episodic across the lifetime when effective treatment is not obtained.  Even with treatment, intrusive thoughts may continue to occur but do not have to interfere with quality of living once a person learns to respond to them differently (without rituals).

Effective treatments for OCD include exposure with response prevention (ERP, the “gold standard” behavioral intervention) and medication management.   ERP involves coming into contact with various triggers of obsessive thoughts (i.e., the “exposure”), then allowing oneself to feel anxious instead of trying to alleviate the anxiety by ritualizing (i.e., the “response prevention”).  Cognitive and mindfulness strategies are often helpful in conjunction with these treatments.  Obsessive thoughts are often viewed by the person experiencing them as evidence that s/he is morally bad, dangerous, or insane.  Cognitive intervention for OCD focuses on correcting these misattributions for obsessive thoughts.  Mindfulness practices can help people observe the body sensations of their anxiety and distress with acceptance instead of judgment, and focus on the task at hand while resisting the urge to ritualize during ERP, for example.

Jonathan Grayson, PhD, a leading authority on the treatment of OCD, and Gayle Frankel (President of the Philadelphia Affiliate of the Obsessive Compulsive Foundation at the time) began a support group for sufferers in Philadelphia over 30 years ago with the purpose of trying to prevent relapse in people who had undergone treatment for OCD.  With experience, they learned that dividing the group into three segments provided a necessary and productive structure.  The GOALS Group (Giving OCD-Sufferers Another Lifestyle) begins with a period of discussion of a topic related to OCD, then moves to a time for each attendee to plan a specific task to practice (e.g., a ritual reduction and/or an exposure) between groups, and ends with a period of completely social time for conversation and connecting.  That original group survives today, and has been the inspiration for many other groups across the country.  (See the Handbook for their GOALS group, here:

I started the Worthington, Ohio (northern suburb of Columbus) GOALS group in January 2013 and facilitate it twice per month.  We are a little broader in our goal-setting portion of the group, encouraging not only ERP tasks but also mindfulness strategies, self-monitoring of symptoms, and exercise or other forms of self-care—essentially anything specific that a person can work on to have a positive impact on his/her OCD.  Participants are encouraged to tell their stories, to support one another, and to actively choose to behave according to what they value in life rather than what the OCD “tells” them to do.  (If you are familiar with Acceptance and Commitment Therapy, you can probably see how this combination of mindfulness of emotional and cognitive experience coupled with value-based behaving fits very well with ERP.)  Our GOALS group offers a combination of education and encouragement (not only from the facilitator but more importantly from participants with experience living with OCD), and supportive connections with others who truly understand how frightening and frustrating it can be to live with this brain condition.  Some participants come regularly, others occasionally, but almost all have commented that they have found it valuable both to be understood and to have reinforcement (and sometimes new information) regarding strategies for combatting OCD.  The group is intended as an adjunct to, not a replacement for, psychotherapy.

No direct referral is necessary.  Anyone age 18 and up who believes s/he has OCD is welcome to simply show up.  There is an informed consent form explaining some group parameters that is given to each attendant at the first visit.  For details on the time and place of the group, check the Mental Health America Franklin County (our sponsor)’s website, here:

For much more information on OCD and its treatment, see the International OCD Foundation’s website, here:

For a terrific self-help book on OCD (also a wonderful learning resource for practitioners), see Dr. Grayson’s recent book, “Freedom from Obsessive Compulsive Disorder,” Updated Edition, 2014:

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Beth McCreary, PhD, is a psychologist in her own private practice (Anxiety and Behavioral Health Services) in Worthington, Ohio.  She specializes in cognitive and behavioral interventions for anxiety disorders, and incorporates elements of mindfulness and acceptance and commitment therapy into her work.  Dr. McCreary obtained her doctorate from The Ohio State University (OSU) and completed postdoctoral work that included clinical training from the Anxiety and Stress Disorders Clinic at OSU as well as a research component through Johns Hopkins University.  She has presented on the treatment of anxiety disorders to other practitioners and does some individual consulting as well.