I’ve always felt that one of the most difficult aspects of obsessive-compulsive disorder is finding the right treatment. Evidence-based exposure and response prevention (ERP) therapy, a type of cognitive-behavioral therapy (CBT), is the first-line treatment for the disorder, and it works. Yet so many people, including therapists, have never even heard of ERP. This is so unacceptable! I am doing my best, along with other advocates for OCD awareness, to help spread the word.
But knowing that ERP therapy is what you need is only half the battle. The other half is finding a good therapist who is properly trained in ERP and really knows how to utilize it correctly. Imagine thinking you are getting good ERP therapy when in actuality you’re not. You wonder why you’re not getting better; after all, ERP is supposed to work. Maybe you’re even feeling worse. You worry that your OCD is not treatable. After all, ERP is the gold standard for treating OCD. You lose hope.
So how do you find a good OCD therapist? If you live in or near a metropolitan area, check out major universities as well as centers for anxiety. Often they will have OCD specialists, or at the very least, should be able to give you some referrals.
If you don’t live near a big city or university, you can certainly ask your general practitioner. But beware! A lot of doctors don’t realize there is specialized treatment for OCD and may just recommend a local therapist. This is exactly what happened to my son Dan. He spent four months getting the wrong treatment, with disastrous results.
The International OCD Foundation website can be helpful in finding a competent therapist. It also provides a list of questions you should ask potential health care providers.
Once you are working with a therapist, how can you tell if you are getting good ERP therapy? Below are a few things to look out for:
- If you have been seeing the same therapist for years and have not made significant strides, then it is probably a good time to reevaluate your situation. It shouldn’t take that long. In fact, if you have a great therapist and you are motivated to fight your OCD, positive results can be seen surprisingly quickly. I know of people who have had OCD for 20 to 30 years, and with proper treatment they have recovered in 12 weeks and have also acquired the tools needed to maintain their good health.
- A good OCD therapist doesn’t tell you what to do. Rather your ERP therapy should be a collaborative effort, whether you are talking about what should be included in your hierarchy or which exposures you should be attempting. Good ERP therapy is client-driven.
- A common mistake therapists make is to reassure the person with OCD. While this might temporarily reduce the person’s intense anxiety, it serves only to fuel the fire of obsessive-compulsive disorder. If your therapist regularly reassures you in any manner, that’s a huge red flag that he or she might not know the proper way to treat OCD.
- It is important for a good therapist to encourage you to challenge yourself as much as possible, without actually forcing you to do anything. The higher up you can get on your hierarchy, the greater chance you have of beating OCD.
- A good therapist assists you in becoming your own therapist, so that you will have the lifelong tools to fight your OCD.
While the above is by no means an exhaustive list, I think it’s a good start.
When Dan left his intensive residential treatment program, we connected with a therapist who told us he specialized in treating OCD with ERP therapy. Once we heard that, my husband and I didn’t ask any questions or request any specifics about his approach. I realize now how incredibly lucky we were, as this psychologist turned out to be an excellent therapist with extensive experience using ERP. Of course, not everyone is so fortunate, so we should all educate ourselves about OCD and its proper treatment as much as possible.