How can therapy help me handle my OCD and anxiety problems?

Anxiety and obsessive compulsive disorder (OCD) continues to be under diagnosed and misdiagnosed leaving individuals struggling with ineffective and sometimes harmful treatments. Both the American Medical Association (AMA) and American Psychological Association (APA) recommend Exposure and Response Prevention therapy coupled with medication as an effective form of treatment for OCD and anxiety. OCD treatment, unlike some other disorders, benefits greatly from a clinician trained specifically to deal with the uniqueness of this disorder. OCD and most anxiety-based disorders use a behavioral exposure based component in treatment – Exposure and Response Prevention therapy. This makes the treatment more collaborative and participatory as a rule. The treatment involves more than just “talk”. Therapy can also provides support, problem-solving skills, and enhanced coping strategies for issues that can get in the way of your ability to manage anxiety. Issues like: depression; relationship troubles; unresolved childhood issues; grief; stress; body image issues; and creative blocks. Many people also find that good treatment can be a tremendous asset to managing personal growth, interpersonal relationships, family concerns, marriage issues, and the hassles of daily life. Therapists can provide a fresh perspective on a difficult problem or point you in the direction of a solution. The benefits you obtain from therapy depend on how well you use the process and put into practice what you learn. Some of the benefits available from therapy include: Attaining a better understanding of yourself, your goals and values. Developing skills for improving your relationships. Finding resolution to the issues or concerns that led you to seek therapy. Learning new ways to cope with stress and anxiety. Managing anger, grief, depression, and other emotional pressures. Improving communications and listening skills. Changing old behavior patterns and developing new ones. Discovering new ways to solve problems in your family or marriage. Improving your self-acceptance and boosting self-confidence. Appropriate management of OCD or other anxiety disorders.

Do I really need therapy? I can usually cope.

In terms of OCD people can take years to find an appropriate treatment. In general, everyone goes through challenging situations in life, and while you may have successfully navigated through other difficulties you’ve faced, there’s nothing wrong with seeking out extra support when you need it. In fact, therapy is for people who have enough self-awareness to realize they need a helping hand, and that is something to be admired. You are taking responsibility by accepting where you’re at in life and making a commitment to change the situation by seeking therapy. Therapy provides long-lasting benefits and support, giving you the tools you need to avoid triggers, re-direct damaging patterns, and overcome whatever challenges you face.

Why do people go to therapy and how do I know if it is right for me?

People have many different motivations for coming to psychotherapy. Some people have poor treatment outcomes related to OCD or other anxiety disorders. Some may be going through a major life transition (unemployment, divorce, new job, etc.), or are not handling stressful circumstances well. Some people need assistance managing a range of other issues such as low self-esteem, depression, anxiety, addictions, relationship problems, spiritual conflicts and creative blocks. Therapy can help provide some much needed encouragement and help with skills to get them through these periods. Others may be at a point where they are ready to learn more about themselves or want to be more effective with their goals in life. In short, people seeking psychotherapy are ready to meet the challenges in their lives and ready to make changes in their lives.

What is therapy like?

Because each person has different issues and goals for therapy, therapy will be different depending on the individual. In general, you can expect to discuss the current events happening in your life, your personal history relevant to your issue, and report progress (or any new insights gained) from the previous therapy session. Depending on your specific needs, therapy can be short-term, for a specific issue, or longer-term, to deal with more difficult patterns or your desire for more personal development. Either way, it is most common to schedule regular sessions with your therapist (usually weekly). It is important to understand that you will get more results from therapy if you actively participate in the process. The ultimate purpose of therapy is to help you bring what you learn in session back into your life. Therefore, beyond the work you do in therapy sessions, your therapist may suggest some things you can do outside of therapy to support your process – such as reading a pertinent book, journaling on specific topics, noting particular behaviors or taking action on your goals. People seeking psychotherapy are ready to make positive changes in their lives, are open to new perspectives and take responsibility for their lives.

What about medication vs. psychotherapy?

It is well established that the long-term solution to mental and emotional problems and the pain they cause cannot be solved solely by medication. Instead of just treating the symptom, therapy addresses the cause of our distress and the behavior patterns that curb our progress. You can best achieve sustainable growth and a greater sense of well-being with an integrative approach to wellness. Working with your medical doctor you can determine what’s best for you, and in some cases a combination of medication and therapy is the right course of action.

Do you take insurance, and how does that work?

To determine if you have mental health coverage through your insurance carrier, the first thing you should do is call them. Check your coverage carefully and make sure you understand their answers. Some helpful questions you can ask them: What are my mental health benefits? What is the coverage amount per therapy session? How many therapy sessions does my plan cover? How much does my insurance pay for an out-of-network provider? Is approval required from my primary care physician?

Does what we talk about in therapy remain confidential?

Confidentiality is one of the most important components between a client and psychotherapist. Successful therapy requires a high degree of trust with highly sensitive subject matter that is usually not discussed anywhere but the therapist’s office. Every therapist should provide a written copy of their confidential disclosure agreement, and you can expect that what you discuss in session will not be shared with anyone. This is called “Informed Consent”. Sometimes, however, you may want your therapist to share information or give an update to someone on your healthcare team (your Physician, Naturopath, Attorney), but by law your therapist cannot release this information without obtaining your written permission.

However, state law and professional ethics require therapists to maintain confidentiality except for the following situations:

  • Suspected past or present abuse or neglect of children, adults, and elders to the authorities, including Child Protection and law enforcement, based on information provided by the client or collateral sources.
  • If the therapist has reason to suspect the client is seriously in danger of harming him/herself or has threated to harm another person.

What is MBSR, Mindfulness-based stress reduction?

Mindfulness-based Stress Reduction is an eight week course devised by Jon Kabat-Zinn. Ph.D. at the UMASS Medical School. Since its inception in 1979 it is now in practice in more than 200 medical facilities acorss the country. It continues to grow and is being used in varying programs throughout not only the USA but abroad. Since the initial successes of MBSR it has been funded for manv studies that consistently supporst its usefulness. While originally developed to aid management of stress and chronic pain, MBSR has been shown to help with a host of other issues as supported by the study below:Grossman P, Niemann L, Schmidt S, Walach H: Mindfulness-based stress reduction and health benefits. A meta-analysis. J Psychosom Res, 2004; 57: 35-43

This study reviewed 20 prior studies (involving an aggregated total of 1605 people) on Mindfulness-based Stress Reduction (MBSR).  Fifteen of the studies dealt with a variety of medical conditions (cancer, pain, obesity, anxiety, etc.), two dealt with prison populations, and three dealt with non clinical (i.e. ‘normal people’) groups who took the MBSR course.The results were encouraging: “Our findings suggest the usefulness of MBSR as an intervention for a broad range of chronic disorders and problems. In fact, the consistent and relatively strong level of effect sizes across very different types of sample indicates that mindfulness training might enhance general features of coping with distress and disability in everyday life, as well as under more extraordinary conditions of serious disorder or stress“.The researchers also found that “…improvements were consistently seen across a spectrum of standardized mental health measures including psychological dimensions of quality of life scales, depression, anxiety, coping style and other affective dimensions of disability. Likewise, similar benefits were also found for health parameters of physical well-being, such as medical symptoms, sensory pain, physical impairment, and functional quality-of-life estimates, although measures of physically oriented measures were less frequently assessed in the studies as a whole“.

If you have other questions about Anxiety or OCD Treatment, especially as it pertains to our Philadelphia and / or Main Line offices, please do not hesitate to contact me. We typically get back to you within 24 hours.