OCD Treatment

OCD and spectrum disorders are usually treated with a combination of medication and Cognitive Behavioral Therapy. Exposure-Response-Prevention, a form of cognitive behavioral therapy, is the primary technique used to treat OCD.

Habit Reversal Training, which uses many different cognitive behavioral techniques, is very effective in treating Impulse Control Disorders and tics.

EXPOSURE-RESPONSE-PREVENTION therapy consists of gradually learning to tolerate the anxiety associated with a triggering event or situation. For example, a child who refuses to go to school because of germs might touch something only very mildly “contaminated” (such as a tissue that has been touched by another tissue that has been touched by a book that came from the “contaminated” location, in this case the school). That is the “exposure.”

The “response prevention” is not washing, changing clothing, etc. After habituation occurs, the child moves to a more difficult task such as omitting one of the tissues, then touching the book, and ultimately going to the school.

When the feared event is a break-in and the compulsion or response has been multiple lock-checks, the exposure may be leaving the house and checking the lock only twice without going back, then checking only once without going back. Then the person can progress to leaving home without rechecking the lock at all.

When the exposure is done properly, a person can quickly habituate to the anxiety-producing situation and will discover that their anxiety level has dropped considerably without performing the response behaviors or compulsions.

Obsessions without obvious compulsions can also be treated using Exposure-Response-Prevention by addressing avoidances and subtle mental compulsions.

HABIT REVERSAL TRAINING includes awareness training, stimulus control, competing response training, and relaxation training. The first step is to become aware of the full context in which the behavior occurs. Steps can then be taken to modify the stimulus and to create a competing response.

Using relaxation training or other coping strategies can also be an important part of gaining control.