Obsessive-compulsive disorder is an often misunderstood and misdiagnosed disorder. Indeed, estimates indicate that it can take from 14-17 years from the onset of symptoms to get an accurate diagnosis and effective treatment for OCD. Even when a proper diagnosis is made, choosing the appropriate treatment program can be confusing and overwhelming. It is not unusual for those seeking help to be steered in the wrong direction by professionals who are not familiar with the best options for treating OCD.
I speak from personal experience as my son Dan suffered with severe OCD.
As an advocate for OCD awareness and proper treatment I hear from many people who have OCD or who are trying to help a loved one suffering from the disorder. One of the most disheartening scenarios that seems to come to my attention more and more is the involuntary (or even voluntary) hospitalization of people (children and adults) with severe OCD. To be clear, I am talking about inpatient psychiatric hospitals for the treatment of serious brain disorders. These hospitals are a good fit for people who pose a danger to themselves or others. In general, these hospitals are not helpful to those with OCD, and in fact often lead to an exacerbation of the disorder.
How do those struggling with severe OCD end up in psychiatric hospitals? Each situation is unique of course, but in many cases, those with OCD are refusing treatment of any sort and are not able to perform activities of daily living such as dressing, feeding, and bathing themselves. They often cannot leave their home, and their lives might be overtaken with compulsions (think showering for seven hours at a time). It truly is heartbreaking to witness a loved one in this condition and when professionals recommend inpatient psychiatric care, it can seem to make sense, on the surface at least.
Why are these hospitals not a good fit for those in the throes of severe OCD? For one thing, taking people with severe untreated OCD out of their perceived “safe zone” so abruptly is likely to be traumatizing. Also, there is a specific evidence-based therapy for OCD called exposure and response prevention (ERP) therapy, and this is not offered at inpatient psychiatric hospitals. Talk therapy is more likely to be employed, and this often hurts more than it helps.
So if psychiatric hospitals are not a good fit for those dealing with severe OCD, what treatment options are appropriate? Well, for one, any treatment program for OCD should be staffed with professionals trained to treat OCD using ERP therapy. Beyond that, individual factors should be considered when choosing the best fit from the list below:
- Residential Treatment Centers for OCD – These are specifically for those with OCD and are intense programs. Patients typically have to be willing to tackle ERP therapy to be admitted. At times patients will be allowed off campus to work on their therapy. Length of stay can vary from one week to up to several months.
- PHP (Partial Hospitalization Programs) – These are similar to residential programs except patients do not live there. Individual therapy and group classes typically take three to eight hours a day, four to five days a week. Sometimes patients (and family members) will live in nearby hotels (or Ronald McDonald houses). Length of stay typically varies from one week to two months.
- IOP (Intensive Outpatient Programs) – The format can vary, but some OCD therapists offer intense therapy (for example, three hours a day, five days a week) for a specific length of time. Patients either travel daily to therapy or stay in accommodations nearby.
- OCD Therapy Sessions – These are individual therapy sessions typically once or twice weekly with an OCD specialist. Sessions usually last an hour.
This is just a general overview of treatment options for OCD. They are all voluntary and patients can choose to leave at any time, though children must have the consent of their parents.
For those with severe OCD who refuse any treatment, I’d recommend that loved ones meet with an OCD specialist who will help them understand the best ways to move forward by not accommodating their loved ones.
It is not an easy journey, but OCD, no matter how severe, is treatable. Sometimes finding the right help is half the battle.