Below are 7 tips I have compiled based on my experience using evidence-based treatments with individuals with Obsessive-Compulsive Disorder (OCD). While each patient is unique, I have seen the following points correlate strongly with successful treatment outcomes.
Tip #1. Fully Understand the Rationale for Exposure and Response Prevention (ERP)
ERP is the gold-standard treatment for OCD, and while you may be eager to get started, rushing into a challenging treatment like ERP is likely to backfire if you do not have a proper understanding of why this treatment is being recommended, and why it works. The first step in proper OCD treatment is psychoeducation, meaning your therapist will take time to review the treatment rationale, and may even provide you with information to read between sessions. Take notes, ask questions, and remember that this step is just as important as the ERP exercises themselves. If your therapist supplements ERP with Acceptance and Commitment Therapy (ACT), it is equally as important to understand the rationale behind these techniques as well. A helpful way to gauge whether you have a good understanding of your treatment is to see how well you can explain its rationale out loud, whether to yourself, or to a close family member or friend.
Tip #2. Be open and willing to engage in challenging treatment exercises
and more importantly, be open and willing to experience the discomfort they will elicit. There are no shortcuts in treating OCD, and for many individuals, working with their therapist to develop a willingness to approach their triggers is a crucial first step. How open and willing you are will often depend on the degree your symptoms interfere with your daily functioning. A greater willingness will come when your reasons for making a change outweigh your reasons for not making a change. Before engaging in treatment, this is a good reflection point to consider.
Tip #3. Complete all homework assignments.
This is essential. You will not reap the benefits you are looking for by only participating in treatment during your weekly therapy session. Treatment for OCD symptoms requires practice every. single. day., and in a manner that is focused and intentional. Rushing through your homework, or pushing it off until a "better time" later in the week, is not a helpful strategy that will allow for progress to be made. If you find yourself hesitant to experience the discomfort associated with ERP homework, the first part of treatment will involve developing the openness and willingness described in tip #2 above.
Tip #4. Be honest with yourself (and your therapist).
I cannot stress this enough. If a specific ERP exercise is too challenging, or you are struggling with your homework assignments between sessions, please speak up. Fibbing about how much effort you are putting into treatment between sessions will not help you progress in your recovery. Your therapist is not there to judge you; instead, he/she will work with you to overcome any obstacles you are experiencing, and get you back on track with an ERP program that works best for you. If you are finding ERP as a whole to be overwhelming, it is okay to say so. Together, you and your therapist can pause and reflect on what helpful changes to your treatment plan may need to be made to best help you succeed.
Tip #5. Be mindful of not taking on additional responsibilities and stressors during treatment.
This is not the time to volunteer to organize your child's school fundraiser, plan a long vacation, or overload your schedule at school. OCD treatment requires time, dedication, and a commitment. Time-wise, it can feel similar to starting a part-time job, or taking an extra class in school. Also, keep in mind that OCD treatment will initially raise anxiety and discomfort levels. If stress levels are high in other areas of your life, it can be more challenging to tolerate, and want to tolerate, the elevated stress levels from engaging in ERP. For some, the first step of treatment may be exploring ways to reduce the number of stressors on your plate.
Tip #6. Make OCD treatment a lifestyle
As you begin to progress in treatment, it is important to continuously confront the triggers you've successfully worked on as they spontaneously show up in your daily routine. It can be tempting to lose focus on these triggers once you begin confronting more challenging items, but it is essential to continue targeting "old" triggers as they show up, even if they are showing up less frequently. Think about what would happen if you succeed at losing weight through a healthy diet and exercise program, only to go back to your old habits once you achieved your goal? While there is no cure for OCD, it can absolutely be managed, (and managed well!) by incorporating skills into your everyday life.
Tip #7. If ERP remains challenging, consider supplementing therapy with medication.
While I will always support those who choose to engage in treatment without medication, I would be doing them a great disservice by not discussing the benefits of medication, especially if they find it challenging to get started with, and consistently engage in, ERP treatment. For many individuals, medication is the helpful step needed to break through barriers and experience the success they are looking for.
DISCLAIMER: The blog posts shared on www.StacySmithCounseling.com contain the opinions of Stacy Smith, MS, LPC, and do not reflect the opinions of any organizations or affiliates. While Stacy is a licensed mental health professional, all blog posts on her site are for informational purposes only, and are never a substitute for professional advice catered to your individual needs. Stacy Smith is not liable for any diagnosis, treatment plans, or decisions made based on the information presented on this website.