Monday, June 29, 2015
OCD: Treatment via Support Groups
By Guest Blogger Beth McCreary, Ph.D.
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:
http://mhafc.org/get-help/support-groups/ocd/
For much more information on OCD and its treatment, see
the International OCD Foundation’s website, here: https://iocdf.org/
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:
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.
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