Should You Trust Your Therapist? Depends.

Got this excellent question from a blog reader:

I think I have HOCD but I’m not sure. My therapist is doing CBT but I don’t think it’s ERP and it’s making me anxious. Like what if this therapy goes know where and just becomes me talking about my problems.(what happened with my last therapist). Should I trust that she knows what she is doing? Her Website says she does CBT so by saying she does CBT does that mean she is also an expert on ERP?

It’s sad, but so many mental health professionals are not very educated on OCD or how to treat it. CBT (cognitive-behavioral therapy) is a pretty vague, blanket term, whereas ERP (exposure and response prevention) is a specific type of CBT.

Two things I’d suggest:

  1. Read up about ERP. As much as you can. It will help you recognize if it is being done correctly. Start with this article on the IOCDF website. Also read any/all of the CBT/ERP posts at www.jackieleasommers.com/OCD.
  2. Ask your therapist the following questions. These questions– and the answers you should listen for— are pulled from this page on the IOCDF website.
  • “What techniques do you use to treat OCD?”If the therapist is vague or does not mention cognitive behavior therapy (CBT) or Exposure and Response Prevention (ERP) use caution.
  • “Do you use Exposure and Response Prevention to treat OCD?”
    Be cautious of therapists who say they use CBT but won’t be more specific.
  • “What is your training and background in treating OCD?”
    If they say they went to a CBT psychology graduate program or did a post-doctoral fellowship in CBT, it is a good sign. Another positive is if a therapist says they are a member of the International OCD Foundation (IOCDF) or the Association of Behavioral and Cognitive Therapists (ABCT). Also look for therapists who say they have attended specialized workshops or trainings offered by the IOCDF like the Behavior Therapy Training Institute (BTTI) or Annual OCD Conference.
  • “How much of your practice currently involves anxiety disorders?”
    A good answer would be over 25%.
  • “Do you feel that you have been effective in your treatment of OCD?”
    This should be an unqualified “Yes.”
  • “What is your attitude towards medication in the treatment of OCD?”
    If they are negative about medication this is a bad sign. While not for everyone, medication can be a very effective treatment for OCD.
  • “Are you willing to leave your office if needed to do behavior therapy?”It is sometimes necessary to go out of the office to do effective ERP.

 

Advocacy & Boundaries

advocacyTwo recent, semi-related questions I received:

  1. Can you give any recommendations for getting involved in the OCD community and doing advocacy work? 🙂
  2. I am getting very drained and upset by certain advocacy interactions. Do you have any advice on how to handle this? 

First,
Getting Involved in OCD Awareness Advocacy

I don’t think I can answer this any better than by directing you to the IOCDF website, specifically this page, which talks about support groups, research studies, OCD Awareness Week, and getting plugged into your local affiliate!

Next,
Proper Boundaries in OCD Awareness Advocacy

I am so happy and eager to help people, but sometimes it’s as if they want different answers, so they keep asking things hoping I’ll suggest something easier than exposure therapy. Or something that alleviates their anxiety immediately. Sometimes asking the questions themselves is the compulsion.

Sometimes it gets to the point where it is damaging to MY OWN mental health or the freedom I worked so hard to achieve via treatment.

In these cases, I have to cut it off.

I can’t be a personal, free, on-call therapist. I can’t be a therapist at all. I can provide resources, and then it is up to individuals to act.

So, set your own standards and stick to them. Be kind but firm. Gently point out when someone appears to be compulsively asking the same questions again and again. Sometimes you might have to say, “I can’t reply anymore.”

One thing that has been especially difficult for me is hearing from people who are in crisis-mode. My own therapist pointed out to me that even she– with her master’s in counseling– is not trained as a crisis counselor. Certainly I– with no formal therapy training at all– am not equipped to handle folks in crisis. It is better to recommend the suicide hotline (1-800-273-8255) or suicide hotline chat (here).

OCD & a Career? You Bet.

Yesterday, I got this question from a blog reader:

Do you think people with OCD can have a successful career? Do you know people who have OCD but also got a great career? Thank you very much Jackie. You’re the best 🙂

careerHello dear, thanks for the question and compliment!

In a nutshell: yes, absolutely!

I am actually enjoying two careers right now: I recruit for a university and write novels. This is such a dream for me because I love-love-love getting to work with high school and college students who are so passionate and in such a wild time of life and transition. And, of course, writing is my calling. I am so grateful to be able to write for a publisher I deeply respect.

In addition:

My friend A is an author and editor.

My friends C and E are therapists.

My friend L is a teacher.

Do we have days where OCD flares up and makes things difficult? Absolutely. But everyone I have mentioned has taken their OCD diagnosis seriously and pursued treatment, which has allowed each of us to continue to thrive in our careers. 

 

#OCDWeek

ocd awareness week

Hey, everyone! It’s International OCD Awareness Week 2015! With that in mind, I just want to write a few words:

OCD is a debilitating anxiety disorder. There’s nothing funny about it.

OCD is treatable. The frontline treatment is Exposure and Response Prevention (ERP) therapy.

I suffered for 15 years before being diagnosed and another 5 before undergoing proper treatment. Just 12 weeks of ERP broke my 20-year bondage.

To God by the glory!