Our program was developed to address all OCD spectrum disorders and phobic disorders. As an institutional member of the International Obsessive-Compulsive Disorder Foundation (IOCDF), Behavioral Sciences provides intensive outpatient OCD treatment by therapists trained through the IOCDF Behavior Therapy Training Institute (BTTI). Using cognitive behavior therapy, the gold standard in obsessive compulsive disorder treatment, compassionate licensed counselors work with individuals to confront obsessions and compulsions.
Patients may engage in therapy in a variety of settings as required to reduce anxiety and the intrusion of obsessions and compulsions in their daily life. Home, public spaces, hospitals, work, and therapy office settings may be utilized depending upon the nature of obsessions and compulsions and the plan developed by the patient, the family, and the therapeutic team.
Key components of the program include exposure and response prevention (ERP). Empirically validated intervention includes cognitive behavior therapy utilizing cognitive restructuring, group therapy (including psychoeducational components), family support groups, and medication consultation as needed. To provide patients with effective treatment, we prefer to work with those available within a 100-mile radius of our offices. Exceptions may be made depending upon the nature of OCD symptoms and the available resources.
Steps to OCD Treatment
The first step is to call us at 256.883.3231 and ask for a telephone screening for our Intensive Outpatient Program. If the patient is considered eligible, they may schedule an appointment for further evaluation and treatment planning. We work with children, adolescents, and adults.
The second step is to meet with one of our professional anxiety counseling staff members for an in-depth evaluation. This process will also identify therapy goals and expectations. We will obtain a history that includes identifying the triggers for anxiety, previous therapy accomplishments, medication usage and family history. There will be checklists and tests to complete which will help identify symptoms and help us in the development of a collaborative treatment plan.
Next, we will outline an initial treatment plan. The plan will often include a combination of in-office, outside treatment, plus homework on your own. You may work with different therapists on different days depending upon the objectives of OCD treatment. Each participating therapist will be a part of your treatment team and will have helped in the development of your plan.
Exposure and Response Prevention (E/RP)
One of the primary goals of CBT is to teach the patient the skills needed to directly confront fear-evoking stimuli without engaging in fear-neutralizing rituals. If this can be accomplished for a sufficient duration of time per trial and consistently across trials, the patient is likely to experience a natural reduction in anxiety and, more importantly, will eventually be able to go about his/her day-to-day activities without the need for elaborate rituals or avoidance repertoires.
Exposure (E) teaches patients to approach their anxiety or fear-producing stimuli. Response prevention (RP) entails the prevention of mental or physical rituals meant to reduce fear or anxiety.
We emphasize E/RP and use cognitive techniques with the goal of helping patients learn from repeated experience that the feared consequences don’t occur and that their anxiety reduces over the course of time.
Upon completion of the clinical interviews, history, assessments, and after the patient’s treatment goals have been defined, the OCD treatment team meets in collaboration with the patient to target obsessions, compulsions, and avoidance behaviors. Interventions are planned with consideration given to the patient’s observed capacity to tolerate discomfort generally focusing on triggers that evoke moderate levels of anxiety. Then, beginning with the moderate level, the patient gradually works up the hierarchy leading to the more difficult triggers. OCD treatment begins with psychoeducation to prepare the patient for the approach and methods for learning to habituate to triggers and tolerate anxiety. Medication consultations may be a part of this process, but generally we prefer to take the patient as they are so that we are not changing too many variables at one time.
Each patient usually has a 90- to 120-minute or more individual session each work day with a staff therapist. Staff members may participate with the patient in ERP in the community two hours or more daily until the patient is beginning to carry out exposure with friends, family, or independently.
Other Mental Disorders
When treating OCD patients, we take into account coexisting depression and other conditions they may have. We have worked with patients with Asperger’s, bipolar disorder, depression (including teenage depression), and other disorders on a case-by-case basis. Our approach with other disorders is consistent with cognitive behavioral principles. We do not work with individuals who are recently suicidal, actively engaged in substance abuse or those with intellectual functioning below a measured IQ of 80.
Family, Friends, and Other Participation
Part of our process involves the participation of family members and significant others in psychoeducation and our family support group. Family members and others may be enlisted to help with homework, especially in the area of ERP. Children always have a behavior modification component that includes reinforcement and contingency management. Friends may accompany patients to facilitate social and other exposure. Teachers may be asked to participate in resisting reassurance and provide contingency management in the classroom. We consult with teachers, principals, and counselors in the schools when needed.
OCD treatment plans can last from three to eight weeks. When nearing the end of a patient’s OCD treatment plan, we work with them to develop a relapse prevention plan consisting of group support, self-directed ERP, medication management, and therapist consultation as planned.
Our service area includes Limestone County, AL (Athens, Decatur), Madison County, AL (Madison, Huntsviille), and Guntersville, AL.