By Dr. Maha Zayed
How did you choose your primary care physician? Did you find someone based on location, training, or word of mouth? When you go to that physician, do you often ask for a specific treatment, or do you accept what the doctor gives you? When most people go to the doctor, they often accept what is provided. Put simply, we assume the doctor is the expert and knows what s/he is doing. We do not consider the many possible treatments available, and we often get treatment based on what the doctor was trained in or what they feel comfortable with. Unfortunately, these treatments may not always be effective. To counter this, there has been a greater push to have patients research treatment options. Doing so makes the patient an advocate for themselves.The same approach holds true when choosing a therapist. Treatments have traditionally been provided based upon how the therapist was trained and not necessarily what is evidence-based. In addition, clients are taught to find the right fit or someone they feel connected too, and while this is important, making sure the treatment is supported by research is equally if not more important. With clients acting as advocates for themselves, it is more likely that clients will receive treatment that not only feels like a good fit with the therapist, but is also evidence-based.
Moreover, at what point would you decide to see a specialist versus a general practitioner? Would you want your general doctor treating heart disease versus a cardiologist? Patients struggling with anxiety and OCD are encouraged to consider the same question: Would you prefer a general therapist or an anxiety and OCD specialist?
There is a substantial amount of research that supports Cognitive Behavioral Therapy (CBT; see https://adaa.org for more information about CBT) for anxiety disorders and a more specific type of CBT called Exposure with Response Prevention (ERP; see https://iocdf.org for more information about ERP) as the gold standard treatment for OCD. The good news is that these treatments do work. Unfortunately, it takes many sufferers years to find the right treatment. According to estimates, for OCD sufferers, it takes between 14 and 17 years from the onset of symptoms before finding proper treatment. This is far too long! Similarly, at our clinic we get many calls from clients who report they have been in treatment for many years or completed various rounds of treatment and are still not doing well, and haven’t received the relief they expected. They feel hopeless and helpless. They come to us saying that treatment doesn’t work when in fact it seems they have not recieved the right treatment or an been provided an effective treatment “dose”. Sometimes, they say they received CBT, but it sounds more like talk therapy. I try to provide hope that they can get better; that CBT works for anxiety.
So as the consumer, here are several things to ask for when looking for an effective anxiety and OCD therapist:
- Do you provide Cognitive Behavioral Therapy and specifically Exposure with Response Prevention?
- Have you received specialized training in exposure-based therapies (i.e., graduated from a Behavior Therapy Training Institute, attended a graduate program focused on behavior therapy)?
- Are you able to do what is necessary to create and complete effective exposures like leaving the office?
- Can you see me more than once a week for 50-60 mins if need be; can you set up treatment intensively?
- Do you work at a place that specializes at seeing OCD and anxiety clients and have you been successful at it?
CBT when administered correctly is very structured, goal oriented, skills based, and requires practice outside of sessions. It is composed of several components including psychoeducation, identifying how thoughts affect feelings and behaviors and adapting unhealthy stuck thoughts, and behavior therapy. Behavior therapy includes exposure or facing fears, problem solving, learning skills and practicing healthy coping skills. Often times, it requires patients to engage in treatment more than once a week. For example, for OCD, it can be very helpful to set up treatment intensively to start for a few weeks and then to taper down as patients feel more competent and confident in their abilities to implement treatment interventions. In addition, depending on the fear, it may require sessions outside of the office or where the anxiety occurs (e.g., home, school, cars, shopping mall etc.).
I have seen clients who come in hopeless and exhausted get better time and time again with the right treatment. If you are looking for an effective OCD and/or anxiety specialist, feel free to call to speak to one of The OCD & Anxiety Center therapists. You can reach us at 630-522-3124. We can also help you find someone in your area, and we are happy to answer any questions you may have.