Description of Treatment

Treatment Approach

The program is based on empirically supported research which asserts that intensive specialty treatment, utilizing evidence-based treatment protocols, is most effective in treating severe obsessive-compulsive disorder, obsessive-compulsive spectrum disorders, anxiety disorders (such as social anxiety disorder, panic disorder, posttraumatic stress disorder, and generalized anxiety disorder), and other coexisting conditions. To achieve maximum benefit for patients, the program adheres to the following assumptions:

  1. State-of-the-art evidence-based cognitive-behavioral and/or psychopharmacological treatment modalities should be employed to foster lasting change.
  2. Treatment should be provided in a supportive and caring environment that encourages patients to actively participate in developing their treatment plan
  3. Services should always strive to support, educate, and empower the patient.
  4. The individual’s physical, emotional, social, and economical problems must be attended to throughout treatment.
  5. The long-term goal of treatment should be to establish healthy functioning for not only individuals but alsotheir families.

Assessment

A diagnostic assessment is completed within one week of admission by the patient’s behavior therapist. The behavior therapist utilizes observations, specific interventions, patient and family history, parent and patient reports, past treatment records and (if pertinent) psychological testing, in formulating a cognitive-behavioral case conceptualization. Given the complex presentation of severe OCD and anxiety disorders, this thorough and careful conceptualization is crucial for future treatment to be effective. Assessment findings comprise the foundation of treatment and are shared with the patient and with loved ones who are involved in the patient’s care.

Core Treatment Program

The Houston OCD Program’s behavior therapists specialize in OCD and anxiety disorders treatment to target the issues impacting the patient’s life. Treatment planning focuses on symptom reduction and relapse prevention with the patient’s active involvement in the treatment design. Discharge planning begins upon admission to assure community reintegration and tenure, as well as planning for future treatment to address the long-term care needs of the patient.
The behavior therapist designs and implements the individual treatment plan with the patient and provides initial assessments and evaluations. They conduct individual behavior therapy sessions, as well as family sessions. The direct delivery of the behavior therapy techniques are provided by the behavior therapist and may be supplemented by a residential counselor. Residential counselors are trained to help patients to enhance response prevention by blocking their rituals (or pertinent anxiety reducing behaviors), as well as to implement behavior therapy techniques through the provision of support and coaching to utilize effective coping skills.

Family Education and Support

Throughout treatment, the behavior therapist provides psycho education about OCD/anxiety and the impact such conditions have on family relationships. Behavior therapists coach family members on how to work with loved ones, without providing accommodations or minimizing any enabling behaviors, and how to help boost their loved one’s recovery. It is especially important, in the work with patients who live at home, to include the family in the treatment. Hence, in addition to the work described above, the behavior therapist typically has at least one meeting of either face-to-face or a phone therapy session with both the family and patient each week.

Discharge Planning

Discharge and aftercare planning are an ongoing process, which begins at the onset of treatment. This is completed in both group and individual contexts. As patients near completion of treatment, therapeutic passes from the program to the home are scheduled to promote the application of CBT skills, and to facilitate ways to challenge OCD and anxiety triggers in the patient’s home environment. Every effort is made to find an experienced cognitive-behavioral therapist at discharge, if the patient was not seeing one at admission, in an effort to ensure continued success.

References

Björgvinsson T., Wetterneck, C., Powell, D., Chasson, G., Hart, J., Heffelfinger, S., Azzouz, R., ¬¬¬Entricht, T., Davidson, J., & Stanley, M. (2008). Treatment outcome for adolescent obsessive-compulsive disorder in a specialized hospital setting. Journal of Psychiatric Practice, 14, 137-145.

Björgvinsson T., Hart, J., & Heffelfinger, S. (2007). Obsessive-Compulsive Disorder: An Update on assessment and Treatment. Journal of Psychiatric Practice, 13, 362-372.

Davidson, J., & Björgvinsson, T. (2003). Current and future treatments of obsessive-compulsive-disorder. Expert Opinion on Investigational Drugs, 12(6), 993-1001.

Osgood-Hynes, D., Riemann, B., & Björgvinsson, T. (2003). Short term residential treatment for obsessive-compulsive disorder. Crisis Intervention and Brief Treatment, 3, 413-435.