Obsessive-compulsive disorder, or OCD, has been getting a great deal of attention for some time now (in addition to a general surge in mental health awareness). The demand for efficient OCD treatments has increased accordingly, together with a growing body of research focused on better understanding this mental health condition, as well as how to treat it.
But while the number of available OCD treatments continues to rise, there remains a need to sort through the different options, to make it easier for each individual facing this condition to choose the treatment and expert best suited for them. The following list aims to help with this goal, by breaking down key elements that should be taken into consideration when selecting a mental health practitioner and form of therapy for treating OCD.
First, Some Basic Definitions: What is OCD?
Obsessive-compulsive disorder is a mental disorder defined by obsessive thoughts, compulsive behavior or a combination of the two. OCD-related thoughts include not just individual thoughts, but also thought patterns, beliefs, ruminations, urges or images. They are experienced as intrusive, extremely unwanted, and can cause a great deal of distress.
The most common OCD-related obsessive thoughts fall into four categories, though many more types exist:
Cleanliness or contamination concern.
Worry that a disaster may occur.
Organizing or “just right” thinking.
Taboo thoughts that go against social or moral norms.
OCD-related behavior normally arises as a coping mechanism used by the individual to try and dispel the adverse feelings caused by OCD-related thoughts. Such behavior can include repeated hand-washing (to ward off the belief that they’ve picked up some contact illness), checking and rechecking they locked the door (so an intruder can’t attack them at night), exhausting themselves with organizing their living space until they feel everything is in the “right” place, or distracting themselves with their phone to avoid focusing on an image of a loved one in danger.
Both OCD-related thoughts and behavior cause the individual experiencing them a great deal of anxiety, and end up feeding into one another, as part of a continuous loop. Symptom severity and frequency can also grow over time, adding to the individual’s frustration and significantly harming their quality of life.
A common source of confusion for individuals with OCD is the public’s, at times, inaccurate perception of this condition: since many OCD symptoms enhance the focus on generally universal themes (such as physical safety, good health and maintaining order), some conflate more subdued concerns regarding these topics with having OCD. That said, many individuals do meet the diagnostic criteria for OCD, with approximately 1.2% of US adults facing this condition.
Together with a better understanding of OCD, it is critical to know what questions you should ask a mental health practitioner when considering whether to begin treatment with them. As such, here are several things to consider when consulting with an OCD professional:
Licensing and Technique
Mental health regulations are important to ensure the practitioner and form of treatment we choose meet professional, evidence-based standards. For this reason, upon meeting a mental health professional, ask them some basic information to ascertain their expertise and how effective their suggested treatment is for OCD:
In what field did they study and train?
Do they have a treatment license, and is it from a reputable institution?
Has the treatment they offer been shown to aid in OCD symptom relief?
Several forms of treatment have already been proven to significantly alleviate OCD symptoms. Among them are:
Deep TMS: Deep Transcranial Magnetic Stimulation, also known as Deep TMS, is the only non-invasive medical device to be FDA-cleared for treating OCD. The procedure utilizes magnetic fields to safely and effectively regulate the neural activity of brain structures such as the anterior cingulate cortex, which has been shown to be associated with OCD. The treatment does not require anesthesia and can be incorporated into the patient’s daily routine. It also does not cause any significant adverse or long-lasting side effects.
Psychopharmacology: Certain psychiatric medications have been shown to offer symptom relief for those battling OCD. Among them, selective serotonin reuptake inhibitors (SSRIs) have been FDA-approved to treat this condition. However, these medications often come with side effects that may prove to be too detrimental for patients to continue.
Cognitive-behavioral therapy: A form of psychotherapy, CBT examines the thoughts, feelings, behavior and physical manifestations OCD can include, while trying break up maladaptive patterns in the patient’s life and incorporate new, more beneficial approaches to the triggers they face. Exposure and Response Prevention (ERP) is one of the most common CBT approached used to treat OCD. ERP involves repeated exposure to obsessive triggers, while learning to refrain from ritual compulsions that typically provide fleeting relief.
Experience
Experience can be just as important as a mental health professional’s educational background. Learning through past and present field work, while remaining under the guidance of established experts, can help professionals develop their expertise and gain essential insights into their chosen field. As such, be sure to ask:
How long have they been practicing therapy or mental health treatment in general
How long have they specifically been treating OCD?
How long have they been using the treatment they are currently offering?
What results have they seen among similar patients?
Recommendations
Finding the right treatment or expert for your OCD can be a journey in and of itself, and so it makes sense to ask the people you trust to point you in the right direction. This is where personal recommendations come in handy: consulting with others in your life who have dealt with OCD, or turning to professionals you already trust for a referral can help put you at ease, and connect you with a tried-and-true expert.
For additional points of view, you can also look for online reviews of the professional you are considering seeing. You may also consider joining an in-person or online support group, and soliciting advice or recommendations from peers who have experience with OCD.
Setting
As important as experience and success rates are, if the treatment’s setting does not allow you to follow through with it, the treatment itself won’t end up being effective. The treatment setting is made up of several different factors: time, location, and flexibility. For example, in the case of an individual who has developed a behavioral ritual to calm their anxiety over crossing the street, OCD treatment may eventually require exiting the therapy room and accompanying them to an actual crosswalk. For this reason, it is important to establish what the treatment can and cannot include, and to ask the mental health expert you are considering:
Are they located in a convenient location?
How flexible are they regarding the treatment setting and rescheduling (this is especially important if you have trouble scheduling in advance)?
Are they willing to leave their office if the treatment calls for real-life exposure?
What is their cancellation policy?
Do they conduct sessions via video-chat or over the phone, when necessary?
Treatment Cost
A subset of the treatment setting, treatment cost is unique in its focus on the financial exchange that takes place as part of the treatment, which can complicate and add tension to the patient-healthcare provider relationship. However, it is reasonable to prepare yourself by asking:
How much does the professional charge per session?
Can you afford regular treatment payments, either out of pocket or through your insurance provider?
Are payment plans available, if necessary?
Personal Rapport
Mental healthcare is above all, a very intimate process, and one you would ideally go through with someone you feel comfortable with. For this reason, upon meeting the healthcare professional you are considering seeing, ask yourself:
Do you feel you could eventually open up to them, trust them, and be willing to progress with them along your chosen treatment course?
Will you feel comfortable revealing your private feelings with them, and work through the possible frustration that may arise as you battle such a commonly persistent condition as OCD
Combining Different Forms of Treatment
You may have already come across a treatment option that’s beneficial for you, and are looking to incorporate another treatment into your routine. However, since not all forms of therapy are compatible with one another, it is crucial you ask the mental health practitioner you are meeting with:
Is the treatment they are offering compatible with other treatment courses?
Is it compatible with forms of treatment you are already receiving, particularly medication?
Is the healthcare professional you are meeting with open to the possibility of combining several treatments together?
Are they willing to work with other professionals to offer you the best possible care?
Adverse Side Effects
As mentioned earlier, certain OCD treatment options can cause adverse side effects that may eventually outweigh the benefits received from it. As a result, once you begin a treatment course, it is important for you to stay attuned to the way your mind and body are reacting to it, and ask yourselves:
Can you handle the accompanying side effects?
Are there means suggested by the mental health professional to mitigate any side effects?
When to Stop
On a final note, as you look at the different options before you to treat OCD, please take the above factors into consideration, and remember that an adjustment period, or a change of heart, are also valid choices.
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