Our OCD/Anxiety Program for adolescents (ages 13-17) utilizes Cognitive Behavioral Therapy (CBT) and exposure and response prevention therapy (ERP) to treat OCD, phobias, panic disorder, and school refusal. Clients receive a range of other supporting interventions including group therapy, family therapy, and experiential activities.
Why Community West
The Community West treatment program for OCD and related disorders was developed with the understanding that OCD is a complex, multidimensional condition that looks different in every sufferer. As a result, treatment must be tailored to the specific features of each person’s disorder, the consequences they have on their lives, and the presence of co-occurring conditions that often accompany OCD.
At Community West we offer a multidisciplinary approach that starts with a careful and thorough evaluation of a person’s symptoms, namely their obsessions, compulsions and avoidances, which are the three main components of OCD. We also evaluate the level of insight and resistance a person has at the beginning of treatment. We then assess for the presence of additional disorders or issues that may pose challenges to a successful outcome and must be incorporated into the treatment plan. We use the Yale-Brown Obsessive Compulsive Scale (Y-BOCS) and other objective diagnostic and assessment measures to gain an accurate clinical picture of the person’s condition before we formulate a treatment plan designed to address the challenges that brought the person to treatment.
Treatment for OCD
At Community West we know that the gold-standard and first-line treatment for moderate to severe OCD is exposure and response prevention (ERP), a type of treatment that falls under the category of cognitive-behavioral therapy (CBT). It works by helping the OCD sufferer confront, rather than avoid, places, people and situations that trigger their OCD symptoms. During ERP the person with OCD is taught to tolerate the distress to OCD triggers while at the same time resist the urge to carry out the rituals they typically engage in to relieve their distress. Repeated exposures to this process allow the person to overcome the distress caused by the OCD triggers and relinquish the compulsive rituals that make up the disorder. Every person with OCD receives multiple hours of ERP every day that they are in treatment at Community West, which is typically five days per week in our intensive outpatient program (IOP). They meet with a licensed clinician for an hour of daily individual therapy, followed by at least two additional exposure sessions of ERP. Clients in the partial hospitalization program (PHP) follow the same OCD-specific treatment schedule in addition to collateral therapies such as ACT, DBT, mindfulness/mentalization and art therapy, as well as experiential activities such as yoga and qi-gong.
The Role of Medication
In moderate to severe cases of OCD a combination of ERP and medication is often the recommended course of treatment. Therapeutic doses of serotonin-selective reuptake inhibitor (SSRI) antidepressant medication have been shown to work well in multiple studies. However, SSRI’s often take longer to work for OCD than they do for depression (up to 12 weeks for some people), which highlights the importance of working with a treatment team who is familiar with the challenges of treating OCD.
The Role of Family
During our work with clients who struggle with OCD we also explore the ways in which the disorder affects the sufferer’s family. Parents, children, siblings and other family members of persons with OCD are almost universally impacted by the symptoms of OCD and their consequences. This phenomenon is often referred to as “family accommodation”, which is the tendency for families to respond to a sufferer’s OCD by modifying their lifestyles to “accommodate” to the demands made on them by the condition. Family members often enable the sufferer’s symptoms to “keep the peace” and avoid conflict, but this phenomenon often causes a significant psychological and practical burden on everyone involved. At Community West we understand that treatment tends to go more smoothly when it’s viewed as a family effort, and we strive to provide family members with the education and practical tools they need to help the person with OCD.
Disorders related to OCD
In the OCD program at Community West we also treat a few psychiatric disorders that share similarities and common features with OCD, as well as overlapping symptoms. They are referred to as Obsessive-Compulsive Related Disorders or sometimes OC Spectrum Disorders. Despite the commonalities these conditions share with OCD, it is important to accurately diagnose them because the treatment approach required for each may be different. Sometimes people suffer from OCD as well as one or more of these related disorders:
Body Dysmorphic Disorder (BDD)
Trichotillomania (compulsive hair-pulling)
Excoriation Disorder (compulsive skin picking)
There is a group of anxiety disorders that respond to exposure and other CBT approaches that are effective for OCD and related disorder. At Community West we also treat the following anxiety disorders with cognitive and behavioral interventions:
Social Anxiety Disorder
Separation Anxiety Disorder