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What is an OCD Intensive Program? What is exposure and response prevention (ERP)? What kinds of "intensives" are there? What kind of intensive is the Anxiety Solutions OCD Intensive Program? Why do we think our family-oriented intensive is an important option to consider? ___________________________________________ What is an OCD Intensive Program? Recovering from obsessive-compulsive disorder (OCD) can be quite difficult, and many OCD sufferers find that neither medication nor once- or twice-per-week therapy work well enough. An OCD intensive program (commonly called an "intensive") calls for the patient to engage in several hours of specialized therapy for OCD every day. Typically this means a couple hours or more of therapist-guided exposure and response prevention (ERP) almost every day plus four or more hours of ERP practice between sessions every day. What is exposure and response prevention (ERP)? Exposure and response prevention (also known as exposure and ritual prevention and as ERP) is the form of psychotherapy that has been found to be the most effective at treating OCD. Many other forms of psychotherapy don't seem to help much or even to work at all in treating OCD. That is why almost all OCD intensive programs now utilize ERP, and why we always recommend OCD sufferers seek counselors who are well-trained and experienced in using ERP. ERP involves two components:
It is using these two components together that weakens the OCD symptoms. Research has shown that using either exposure alone or response prevention alone does not work or last. However, using both exposure and response prevention at the same time is difficult. It tends to be quite anxiety-provoking, at least until the patient has completed enough of the therapy for it to reduce the patient's anxiety significantly. So one of the goals of OCD intensive programs is to help patients stick with ERP until it works. What kinds of "intensives" are there? Currently OCD intensive programs fall into one of two categories: inpatient and outpatient. Both provide exposure and response prevention (ERP) therapy every day, and both offer more guidance, support, and practice than standard once- or twice-per-week therapy typically can provide. But there are important differences. Inpatient (or hospital-based) programs require the patient live in the facility while being treated. That means even between-session ERP is typically practiced inside the facility where both hospital counselors and fellow OCD patients may be available for support and guidance. Also, OCD patients are often offered access to other treatment programs at the facility at the same time, such as anger management training, life-skills group therapy, and/or medication management. Some inpatient programs also offer a family therapy component, bringing the family in for a few sessions to address the family issues often caused by and/or complicating OCD. And some take a gentler and more gradual approach to ERP treatment, which can be particularly helpful to OCD patients who are ambivalent about treatment and need help with readiness and motivation. However, this slower approach means treatment may stretch out for months instead of a few weeks. The consequence is that inpatient programs can be expected to be more expensive, to be more restrictive, and to provide less real-world exposures than outpatient intensives, but for some OCD patients the additional services, structure, and guidance may be worth it. Outpatient intensives, in contrast, are often much faster paced, typically lasting from 3 to 4 weeks, during which patients live somewhere nearby (typically a hotel), attend ERP therapy sessions at the therapist's office, and then spend several hours each day practicing exposure and response prevention on their own every day. Instead of easing OCD patients through the anxiety inherent in ERP treatment, the idea is to get them to the benefits (including anxiety-reduction) more quickly. Outpatient OCD intensive programs tend to be modeled after the one developed by Dr. Edna Foa and her colleagues at the Center for Treatment and Study of Anxiety (CTSA). In the CTSA intensive, patients are supposed to begin total abstinence from rituals by the 1st day of exposure sessions and to tackle the top of their fear hierarchy (their most scary thoughts or situations) by their 6th exposure session. That way the rest of the intensive (more than a week) is not spent getting to the scariest situations but repeating them and becoming more and more used to and less and less distressed by them. Although some outpatient intensives offer additional services (such as anger management or family therapy), such programs tend to be much more narrowly focused on treating OCD and its symptoms of obsessions, compulsions (or "rituals"), and avoidance, and the responsibility for between-session ERP practice is more fully on the patient alone (or, in the case of a child with OCD, the patient and a parent). What kind of intensive is the Anxiety Solutions OCD Intensive Program? We designed our OCD intensive program to offer the best of current inpatient and outpatient OCD programs plus some features we believe both types seem to lack. Specifically, we believe both types currently don't pay enough attention to Our standard intensive is a family-oriented intensive OCD program, and from the first day we focus not only on overcominan outpatient program based on the CTSA model including its faster, 3-to-4 week pace, but like but instead of staying in a nearby hotel, the patient is encouraged to rent a furnished apartment or house nearby and to make that temporary "home away from home" as home-like as feasible. That means bringing The most notable deficiency we wanted to address is is a failure by most intensives to adequately address "generalization." Generalization is a
Therefore, our OCD intensive program encourages not only the OCD patient but also as much of the patient's household as feasible to
We worked under Dr. Edna Foa at the Center for Treatment and Study of Anxiety for several years, and we believe in and tend to follow the CTSA intensive model. But we also believe that OCD often involves and affects not only the identified patient but also the patient's family, especially when the patient is a child but also often when the patient is an adult. We also believe that current inpatient and outpatient OCD intensive programs fail to focus enough attention on "generalization" and transition of treatment gains and utilization of ERP techniques from the intensive environment back to the home environment. Therefore, our standard OCD intensive is a 3 to 4 week outpatient program that utilizes both ERP and family therapy and encourages not only the patient but also as much of the patient's household as feasible to
Why do we think our family-oriented intensive is an important option to consider? |
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