Melissa Fasteau, PsyD, Jennifer Sy, PhD, Chad Brandt, PhD, and Keith Klein, MA Present at the 2019 ADAA Conference
ADAA 2019 Conference – March 28-31, 2019 Sheraton Grand Chicago, Chicago, IL
Pray the Gay to Stay: Treating Diverse Themes of OCD
Saturday, March 30: 5:45 PM – 6:45 PM 156C
Meeting Room Level 2
Patients with Obsessive Compulsive Disorder (OCD) experience intrusive thoughts that challenge societal norms and values, including sexual, racial, religious, and other identity-related intrusions. Much of the time, patients experience these thoughts as ego dystonic, resulting in elevated distress and impairment (Sketetee & Barlow, 2002). This roundtable will describe examples of diverse obsessional themes and the effect of such themes on conceptualization and treatment of OCD. For example, some client’s report uncertainty about whether or not their sexual-themed intrusive thoughts about someone of the same sex reflect their sexual orientation (referred to at times as homosexual OCD [HOCD]; Williams et al., 2015). In such cases, disentangling personal values and identities from intrusive thoughts has important implications for implementing multiculturally sensitive interventions. For instance, some patients with HOCD experience ego dystonic fears, at times the fear they may become contaminated or unwillingly transformed into a member of the feared population. Case examples will be used to illustrate effective ways to treat obsessional themes of OCD, therapist challenges, and creative exposures for diverse intrusive thoughts. Specifically, intrusive thoughts to address include religious beliefs and practices, race and ethnicity, disabilities and other diagnoses, personality features, and HOCD. The panel will discuss potential impacts on assessment, case conceptualization, and treatment of OCD within the ERP model with an emphasis on the working alliance and multicultural awareness. Ethics of creating exposures within obsessional themes will be explored. Given the challenges for a therapist to address these themes in a sensitive manner, the panel will discuss managing therapist reactions, the cultural context, and decision points for referrals. These instances will be discussed related to racial and disability fears.
1. Demonstrate assessment and differential diagnosis of OCD and diverse obsessional themes.
2. Identify steps to strengthen the working alliance when ego dystonic fears occur.
3. Recognize ethical implications of creating exposures related to diverse themes of OCD.
Diversity – Yes
Obsessive Compulsive Disorder
Sheraton Grand Chicago 301 E North Water St Chicago, IL 60611
I was with the team when they were at Menninger and when they closed their doors. I’ve had OCD for the last 12 years of my life and before I went into treatment it had literally taken over every aspect of my life. Every move I made was consumed by OCD. The monster made me suffer with rechecking, reassurance seeking, confessions, contamination fears, sexual obsessions, hit and run fears and pretty much everything but hoarding and scrupulosity. It was extremely hard work, but I can now say I have a life back, when before I wasn’t even sure if I’d be living. They taught me the tools to live my life and keep my OCD manageable. The staff was truly amazing and literally saved my life. Although they will say that it was me who did the hard work, without their caring and kind hearts I would never have been able to do it.