Treatment Methods For OCD

Exposure Response Prevention (ERP)

The most widely practiced behavioral therapy for OCD is called Exposure and Response Prevention (ERP). Exposure treatment involves direct (in-vivo) or imagined exposure to objects or situations that trigger obsessions that arouses one’s anxiety. Over time, exposure to these cues leads to decreased anxiety until eventually, exposure arouses little or no anxiety at all. This process is called habituation. Studies show that exposure and response prevention can in fact train your brain, significantly reducing the occurrence of OCD symptoms.

The response component of ERP refers to the act of engaging in ritualistic behaviors in an effort to reduce the anxiety caused by OCD. In ERP treatment, patients learn to resist and prevent themselves from acting on their compulsions, and desire to perform rituals. With successful ERP, the sufferer eventually stops engaging in their ritualistic and obsessive behaviors. ERP helps break the link between your obsessive thoughts and compulsive rituals that will allow you to manage your OCD without the OCD managing you.

Exposure Therapy (ET)

Exposure Therapy (ET) is a form of behavioral therapy that provides the most effective treatment for individuals suffering from anxiety disorders. Exposure therapy can be utilized with general anxiety disorder, social anxiety, post traumatic stress disorder, obsessive compulsive disorder, acute stress, panic attacks or other trauma-related issues and phobias. People that suffer from anxiety recognize that their fears are irrational and exaggerated but are unable to control their fight or flight system and therefore, end up experiencing continuous anxiety. This form of therapy has been scientifically proven to retrain the brain to no longer fear perceived thoughts, objects, people or experiences that used to trigger the sufferer. With Exposure Therapy, clients are able to face and overcome fearful past triggers and relieve anxiety.

Types of Exposures:

• In-Vivo or Live Exposures– These are real life experiences that provide the sufferer with a live experience of confronting that which they fear. Through clinical support and coaching from the therapists, clients are able to engage in a fear or situation while learning the skills and tools to overcome the trigger.
• Imaginary Exposures– These exposures are done through writing and reading techniques. This is usually used when In-Vivo exposures cannot be performed.

With exposure therapy, those suffering from anxiety will be able to “habituate” to the fearful trigger, situation or person, which results in decreased anxiety and increased mental health and happiness.

Mindfulness Based Behavioral Therapy (MBBT)

Using the advances made in the treatment of OCD over the past 10 years, The Gateway Institute incorporates the most current techniques in its treatment programs. Some of these advanced treatments include Mindfulness Based Behavioral Therapy (MBBT). In our practice, we have discovered that a comprehensive treatment strategy that we refer to as Mindfulness Based Behavioral Therapy improves treatment response. In MBBT we incorporate informal mindfulness training along with exposure and response prevention (ERP), and a writing intervention with both behavioral and mindfulness components that contribute to treatment effectiveness.

The focal point of MBBT is to increase one’s awareness of the present as well as recognizing OCD for what it is. Dr. Jeffrey Schwartz, author of Brain Lock, talks about the importance of this approach by taking various steps which include relabeling the OCD such as “It’s not me, it’s my OCD,” and secondly, reattributing OCD to a chemical imbalance in the brain which it is. Dr. Schwartz reminds us that those who suffer from OCD have the capacity to turn the tables on the OCD, and The Gateway Institute will help you do that.

Inference-based CBT (I-CBT)

I-CBT, originating in the 1990s, is increasingly recognized as a valuable treatment modality among OCD specialists.  I-CBT does not involve exposures. Instead, it focuses on teaching clients why they experience certain doubts and how to resolve them by restoring confidence in themselves and rebuilding trust in their own perception and judgment.

From an I-CBT perspective, anxiety and compulsions are downstream byproducts of obsessional doubting. In other words, the “doing” follows the “knowing.” If the obsessional doubt is resolved, there is no anxiety, and consequently, no need for compulsive behaviors.

The target of this treatment is the formation of those obsessional doubts, that formation is known as the Obsessional Reasoning Process, also referred to as Inferential Confusion. This reasoning process is specific to individuals with OCD. Inferential confusion occurs when a hypothetical possibility is mistaken for a real possibility that needs to be acted upon, despite the lack of sensory evidence in the present moment to support it. The OCD sufferer doubts their senses and self, allowing a hypothetical scenario to override their current reality. While I- CBT may take more time in therapy, it can create a resolution of the confusion caused by OCD, eliminating future obsessions from creating new compulsions.

I-CBT can be utilized as a treatment approach within The Gateway Institute’s 3-week OCD Intensive Treatment Program.

Behavioral Therapy Combined with Medication

Though behavioral therapy may be the most effective treatment in terms of long-term management of OCD, research indicates that combining both CBT and medication may be beneficial for overall success. Medications considered for the treatment of OCD are usually antidepressants know as selective serotonin reuptake inhibitors (SSRI), which are often effective without severe side effects. The Gateway Institute works with skilled and experienced psychiatrists to find the right combination of medication to effectively treat OCD when necessary.

Group Therapy

A 2 hour weekly group will be held on Tuesday and Wednesday evenings, and the group’s specific focus involves providing members with support, guidance, and treatment related to their own progress. The group incorporates Cognitive-Behavioral therapy (CBT), and each week home-based challenges are assigned. The group is a great opportunity to establish relations with others who can appreciate the daily challenges of this potentially disabling condition. Sign up for the  OCD/Anxiety Support Group.

Relapse Prevention

Relapse Prevention is an important component of our treatment program. Learning how to manage the OCD will involve a lifestyle change. Since OCD is a chronic condition, a commitment to working diligently on a daily basis while transitioning back into daily life will be necessary. The Relapse Prevention program equips the participant with the necessary tools for success and promotes long-lasting change. Once the symptoms of OCD have improved, a number of strategies can help maintain the gains made, and The Gateway Institute will help devise a plan to help find the road to successfully managing OCD.

Home Visits

For clients with particular subtypes of OCD such as hoarding or contaminating, home-visits may be available to conduct exposure exercises. This allows the therapist to help guide the clients through challenging home-based exercises. Ultimately, these exercises conducted in the presence of the therapist, will be performed independently by the client.