After the diagnosis of Obsessive-Compulsive Disorder (OCD) has been made, the next concern is usually about treatment. A common question is: “What is the best approach and where can I find it?” Concerns about practical matters like finances and availability naturally follow.
Often families ask, “Where can I find OCD treatment in South Florida?”
Depending on where you live, finding practitioners or programs that specialize in OCD can be relatively simple or a nightmare. Although OCD awareness is vastly improved in comparison to even a decade or two ago, unfortunately many areas still lack treatment. Wherever you may reside, the International OCD Foundation (www.ocfoundation.org) is an invaluable resource for obtaining lists of clinicians who are focused on OCD treatment and for qualified programs.
So what is the best form of treatment for OCD? In particular, OCD treatment in South Florida. At present, the interventions with the strongest evidence base are a form of Cognitive Behavior Therapy (CBT) known as Exposure and Response Prevention (ERP), a group of medications called SSRIs, or some combination of both. The efficacy of Cognitive Therapy specifically tailored to addressing OCD-specific thoughts and an approach known as Acceptance and Commitment Therapy (ACT), although regarded as promising, are still being explored.
In the majority of cases, many experts agree that a reasonable trial of ERP, which involves gradually confronting distressing thoughts and situations, should be the first option. This is particularly true for children with OCD. However, when OCD symptoms are extreme or accompanied by severe depression, psychosis, or impaired functioning, starting medication in conjunction with ERP is often necessary. “Medication Alone” treatment of OCD is generally not recommended.
There are many misconceptions about ERP, e.g. that patients are required to face fears they are not ready to confront. On the contrary, the pace of ERP is controlled by the patient not by the therapist. Even better, the skills learned by doing ERP for OCD may become lifelong tools for managing many kinds of anxiety-triggering situations.
A word about PANDAS/PANS: Recently, the possible connection between OCD and infectious illnesses like strep has been receiving a great deal of attention. Currently, the diagnosis and medical treatment of this condition is still being investigated. If this condition is suspected, finding practitioners who are highly experienced in this area is a must.
Although there is a good basic framework for OCD treatment, each case has its own unique aspects. Understanding and addressing these complexities, which include the presence of co-occurring conditions like tics, ADHD, Autism Spectrum Disorder (ASD), age, gender, and family profile is essential for the best prognosis possible. As with many psychological conditions, although there really is no definite “cure” for OCD at the present time, outcomes are improved by early identification and evidence-based intervention. Readiness for change and having a positive support system as well as motivation and cooperation when engaged in the therapeutic process are also relevant factors.
In extremely severe or complicated cases, intensive OCD treatment has been shown to increase the chances of success. There is no “formula” for the exact level of intensity needed or for determining when residential or inpatient treatment is indicated. These major decisions should be made on a thoughtful, case-by-case basis by knowledgeable practitioners and all concerned persons working together to find solutions.
As all who fight OCD effectively come to learn, “there are no guarantees.” This holds true for predicting the potential success in treatment of any given individual. What is known is that evidence-based treatment, consistently applied over time, can yield very positive results. So despite the many challenges associated with OCD, there is truly every reason to be hopeful.
Finally, take a moment to consider this formula and apply it to OCD: Hope x Effective Action= Greater Success. The next step is up to you.
By: Jonathan Hoffman, Ph.D., ABPP
Providing OCD treatment in South Florida