Obsessive-Compulsive Disorder (OCD) Therapy – What it Is, How it Works

Published on: 14 Dec 2018
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Many who struggle with recurrent, intrusive thoughts and behaviors wonder if obsessive-compulsive disorder (OCD) therapy can help them. The disorder is one of the most difficult psychiatric illnesses to understand and, only a few decades ago, it was believed to be a rare psychiatric illness that affected only a small fraction of the population. But now, OCD is known to impact millions of Americans at any given time.

It is a complex and difficult-to-treat condition if not managed correctly by a skilled professional. Thankfully, there are therapy practices that can help alleviate some of the anxiety individuals with OCD feel.

What is OCD Therapy?

Cognitive-behavioral therapy (CBT) is a treatment for OCD that uses two scientifically-based techniques to change a person’s behavior and thoughts: exposure and response prevention (ERP) and cognitive therapy.

Learning to gradually face your fears is one of the most effective ways to break the OCD cycle. ERP involved:

  • Exposing (E) yourself to situations that bring on obsessions (triggers)
  • Not engaging in the unhelpful coping strategies that include compulsions or rituals, and avoidance (Ritual Prevention-RP)

CBT practitioners believe that there are three contributing factors to your anxiety or OCD: the way you think, the way you feel, and the way you behave. While many therapies focus only on the way you think and feel, behavior is the focus of CBT.

Most treatment is conducted at a therapist’s office once a week in three stages: getting to know your OCD better, building a fear ladder, and then climbing the fear ladder. Outside of the therapist’s office, patients are given exercises to practice at home between sessions. If your OCD is very severe, you might need more frequent sessions. Not all mental health professionals are trained in ERP therapy, so it’s important to find one who is.

What if Outpatient ERP Isn’t Working?

If you or a loved one has tried traditional outpatient therapy and would like to try a more intensive level of care, there are options.

The main feature of intensive treatment programs is interdisciplinary care that incorporates the joint expertise of physicians, psychologists, nurses, social workers, occupational therapists and other health professionals to design individualized treatment plans aimed at managing OCD symptoms that have proven difficult to treat using standard therapies.

These programs usually involve staying in the hospital for a specified period of time. While some programs require admission to the hospital for up to three months, other programs may only require admission for a few weeks or even just a weekend.

There are two types of intensive treatment programs available, inpatient and residential:

  • Inpatient treatment programs are for people who may be in danger of harming themselves or others and need immediate care. Admission to the hospital for a select period of time helps avert the medical crisis and get the patient on the right track and to the next step of treatment.
  • Residential treatment programs are for people who are not a risk to themselves or others, but have not responded well to typical OCD treatmentsand need extra help. Residential programs typically take place in a home-like environment where a person stays for a prescribed period of time and receives 24-hour care. The program typically lasts around 60 days but can vary from person to person.

Other Treatment Options for OCD

Although most patients with OCD respond to treatment, some patients continue to experience symptoms. The National Library of Medicine lists medications commonly prescribed in medically assisted OCD therapy. The most effective medications prescribed for obsessive-compulsive disorder are selective serotonin reuptake inhibitors (SSRIs), which are antidepressants. These medications include:

  • Sertraline (Zoloft)
  • Paroxetine (Paxil)
  • Fluvoxamine (Luvox)
  • Fluoxetine (Prozac)
  • Citalopram (Celexa)

If a patient fails to respond to an SSRI, doctors often revert to clomipramine. Clomipramine is an older antidepressant and was the first medication used to treat OCD. Although its effectiveness is greater than that of other medications, it has unpleasant side effects that may make the patient uncomfortable.

Lifestyle Changes That Help Treat OCD

Obsessive-compulsive disorder is a chronic condition, which means it may always be part of your life. While OCD warrants treatment by a professional, you can do some things for yourself to build on your treatment plan:

  • Practice what you learn in therapy: Work with your mental health professional to identify techniques and skills that help manage symptoms, and practice these regularly.
  • Pay attention to warning signs: You and your doctor or therapist may have identified issues that can trigger your OCD symptoms. Make a plan so that you know what to do if symptoms return.
  • Don’t stop taking your medication unless a professional tells you to: Even if you’re feeling well, resist any temptation to skip your medications. If you stop, OCD symptoms are likely to return.

If you or a loved one has been diagnosed with OCD, know you have options. Treatment can be difficult, require a lot of courage and determination, but it can help a person live a more fulfilling life. Having a support network to talk to during treatment of any kind can make all the difference. This support and professional help is the first step to living more comfortably with OCD.

Talkspace articles are written by experienced mental health-wellness contributors; they are grounded in scientific research and evidence-based practices. Articles are extensively reviewed by our team of clinical experts (therapists and psychiatrists of various specialties) to ensure content is accurate and on par with current industry standards.

Our goal at Talkspace is to provide the most up-to-date, valuable, and objective information on mental health-related topics in order to help readers make informed decisions.

Articles contain trusted third-party sources that are either directly linked to in the text or listed at the bottom to take readers directly to the source.

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