OCD Treatment Melbourne26/7/2020
OCD Treatment- Exposure and Response Prevention
The most effective treatments for OCD are CBT and medication.
Approximately 70% of OCD sufferers will derive benefit from exposure and response prevention and/or medication for OCD.(Griest&Jenike,2009)
ERP is more effective than medication, with typical OCD symptom reduction on medication being 40-60% and CBT achieving 60-80% symptom reduction
What is Exposure and Response Prevention (ERP)?
Exposure and response prevention is part of CBT (cognitive behavioural therapy) for ocd. Exposure and response prevention is typically done by a mental health professional such as a psychologist.
Clients usually see their psychologist once or even twice a week for 50 minutes.
The ocd sufferer has to expose themselves to the thoughts, situations, objects and images that trigger anxiety and/or obsessive thoughts.
However, you must refrain from responding to your anxiety or obsessions with a compulsive behaviour .Compulsions are short term anxiety reducers that actually increase obsessions.
During exposure and response prevention you make the choice to expose yourself to your obsessions and experience anxiety, but you also decide not to give into your anxiety and seek relief from it by engaging in compulsive behaviours.
If you repeatedly expose yourself to an ocd trigger and refrain from carrying out a compulsive behaviour, over time you should see a drop in your anxiety level; this is referred to as habituation.
Exposure and response prevention breaks the association between your anxiety and the objects, thoughts, situations that produce this anxiety.
ERP also breaks the association between carrying out rituals and decreasing anxiety.
OCD can be a very debilitating and distressing condition to endure but if you are going to decrease the impact OCD has on your life and reduce your anxiety, you have to stop carrying out the compulsive behaviours which give only temporary relief. Seeking reassurance is an example of an compulsive behaviour. Common compulsive behaviours also include: checking, washing and counting.
Exposure and response prevention – ie OCD treatment is not a walk in the park. Approximately 25% of OCD patients refuse to do ERP and do not complete exposure therapy. However, if you have the fortitude and determination to do ERP it may help you reclaim your life.
OCD Treatment We Provide In Melbourne
- Diagnosis & Symptom Assessment
- Psychoeducation ( information about OCD is given)
- Anxiety Assessment: The SUDS (Subjective Units of Distress)Scale
- The Development of the Exposure Hierarchy
- Eradicating Rituals
- Exposure: In treatment sessions, in vivo, Imaginal, homework
Working with your psychologist you develop an exposure hierarchy.
You make a list of things, places, situations etc that you fear and avoid and think about the reasons you do this (e.g. fear, triggers bad thoughts, doesn’t feel right)
Each item is given a SUDS rating
The items are ranked from least distressing to most distressing
You start off exposing yourself to the easiest items and once you have habituated to an item you move up to the next item on the ladder.
Exposure Hierarchy for OCD
SAMPLE EXPOSURE HIERARCHY FOR SOMEONE WHO OBSESSES ABOUT STABBING PEOPLE
Hold a carving knife whilst sitting on the couch next to a family member 70
Hold a steak knife whilst sitting on the couch next to a family member 60
Carry knives around in a handbag when down the street 50
Leave a knife on the coffee table in the family room 50
Watch a horror movie where people are stabbed 40
Sessions can be done face to face or online. Catherine Madigan , a Melbourne clinical psychologist provides face to face sessions in Hawthorn, Victoria but is also available for online videoconference sessions via COVIU.
You can get help from wherever you live in Australia, without leaving home via videoconferencing on COVIU.
You can access Medicare rebates for sessions with Catherine if you a have a mental health care plan and a separate referral letter stating 6 sessions.
Commonwealth concession card holders are bulk billed.