At some point in a OCD patient’s recovery, it is important that people with OCD try CBT first

 

The OCD Action National Conference recently took place in London. Leading OCD charity, OCD Action, organises the annual OCD Action National Conference to help people with OCD develop their own support network and to give them the chance to hear from leading experts.

The World Health Organisation has listed OCD in their top ten of the most disabling illnesses, decided by lost earnings and diminished quality of life. However, the good news is that it is treatable. There is evidence that a form of cognitive behavioural therapy (CBT) called Exposure Response Prevention can help people with OCD and sufferers are learning to confront their worst fears and regain control of their lives.

In Overcoming OCD, reporter Judy Hobson investigates why people with OCD often don’t seek help until middle age. This can be in spite of the condition usually first emerging in their childhood.

We in transpersonal psychotherapy try to improve a psychological condition by helping clients gain “insight” into their problems and through creative interventions seeking to produce a transformative experience by helping client’s get in touch with their essence. The medical experts suggest, however, that although this approach may be of benefit, at some point in a OCD patient’s recovery, it is important that people with OCD try Cognitive Behaviour Therapy (CBT) first, as this is the type of treatment that has been shown to be the most effective.

This screening test was designed as a guide to find out whether you show symptoms similar to those of Obsessive Compulsive Disorder (OCD).

It is worth noting that:

• The questionnaire is meant for indicative purposes only. It does not mean you have OCD if you obtain a high score as a result of completing this questionnaire. It will be necessary to obtain a trained healthcare professional can diagnosis.
• This test has 20 questions in Part A and 5 questions in Part B and should take about 5 minutes.
• The test was developed by Professor Wayne Goodman of the University of Florida.

Shortly, the revised DSM5 will reclassify OCD into a new category with other OCD spectrum disorders such as BDD, skin picking disorder and hoarding disorder.

Are the medical experts correct with the assertion that at some point in a OCD patient’s recovery, it is important that people with OCD try CBT first? With other illnesses, my psychiatric placement gave me an insight into the limitations of psychotherapy. Some patients are so ill they lack the capacity for insight and a pharmacological treatment plan is critical for their recovery. I believe we need to proceed with great caution when working with clients with psychotic conditions as there is often an absence of a healthy ego. For instance, critics of the transpersonal school argue that those with borderline personality or psychotic symptoms are not appropriate candidates for transpersonal therapy techniques because of the potential for ego defences to be overwhelmed. However, Linehan [1] argues that these conditions can be relative contraindications at best. She used mindfulness techniques and visualisation with borderline patients in Dialectical Behaviour Therapy and suggested that even patients with fragile or unstable ego functioning can benefit from such work. Does this apply to OCD clients? I believe that we need to pay attention to the evidence base but not be a slave to it.

Additional Resources:

What is good CBT
Whats new in the treatment of OCD
Summary of NICE-recommended treatment approach for OCD
The Treatment of OCD and BDD in the NHS Blog post
TOP UK triumph over phobia a UK registered charity which aims to help sufferers of phobias, obsessive compulsive disorder and other related anxiety to overcome their fears and become ex-sufferers.
The Centre for Anxiety Disorders and Trauma provides a national OCD/BDD service
Leaflets on OCD from the Royal College of Psychiatrists
OCD: A web guide for health professionals Contains useful links
Summary of NICE-recommended treatment approach for OCD Stepped care model for treatment of OCD
NICE Guideline: Obsessive compulsive disorder (OCD) and body dysmorphic disorder (BDD) (CG31)

If you are experiencing problems with OCD, refer to SW London and St Georges NHS Mental Health Trust OCD/BDD Clinic.