Our OCD/Anxiety Programs are offered to both adolescents (ages 13-17) and young adults (ages 18-29) and utilize Cognitive Behavioral Therapy (CBT) and exposure and response prevention therapy (ERP) to treat OCD, phobias, panic disorder, and school refusal and avoidance. Clients receive a range of other supportive interventions including group therapy, family therapy, case management, and experiential activities.
Why Community West?
The Community West treatment program for OCD and related anxiety disorders was developed with the understanding that these are complex, multidimensional conditions that manifest differently for every sufferer. As a result, treatment must be tailored to the specific features of each person’s disorder. We also consider the consequences the symptoms have on their lives and the presence of co-occurring conditions that often accompany OCD such as depression, anxiety, and emotional dysregulation.
At Community West we offer a multidisciplinary approach that starts with a careful and thorough evaluation of a person’s symptoms, namely their obsessions, compulsions and avoidances, which are the three main components of OCD. We also assess the level of insight and resistance a person has at the beginning of treatment, along with the presence of additional issues that may pose challenges to a successful outcome. These considerations are incorporated into the treatment plan. We use the Yale-Brown Obsessive Compulsive Scale (Y-BOCS) and other objective diagnostic and assessment measures to gain an accurate clinical picture before we formulate a treatment plan designed to address the challenges that brought the person to treatment. Each client has a different hierarchy of obsessions, compulsions or anxieties, which are identified in the assessment and then addressed in a stepwise fashion. Interventions start with less overwhelming areas and progress toward more difficult domains.
Treatment for OCD
The gold standard and first-line treatment for moderate to severe OCD is exposure and response prevention (ERP), a type of treatment that falls under the category of cognitive-behavioral therapy (CBT). It works by helping the OCD sufferer to confront, rather than avoid, places, people and situations that trigger their OCD symptoms. This approach can also be applied to various kinds of anxiety disorders. During ERP the client is taught to tolerate the distress to triggers while at the same time to resist the urge to carry out the rituals they typically engage in to relieve their distress. In the case of anxiety, this often includes avoidance. Repeated tailored exposures allow the person to overcome the distress caused by the triggers and relinquish the compulsive rituals or avoidances. Clients typically receive multiple hours of ERP every day that they are in treatment, which is typically five days per week in our intensive outpatient program (IOP). They meet with a licensed clinician for an hour of daily individual CBT, followed by at least two additional exposure sessions of ERP. Clients in the partial hospitalization program (PHP) follow the same OCD/anxiety treatment schedules along with additional collateral therapies such as ACT, DBT, mindfulness, mentalization, art therapy, and experiential activities such as yoga and qigong.
The Role of Medication
In moderate to severe cases of OCD a combination of ERP and medication is often the recommended course of treatment. Therapeutic doses of serotonin selective reuptake inhibitor (SSRI) antidepressant medication have been shown to work well in multiple studies. However, SSRI’s often take longer to work for OCD than they do for depression (up to 12 weeks for some people). This highlights the importance of working with a treatment team familiar with the challenges of treating OCD.
The Role of Family
During our work with clients who struggle with OCD or anxiety we also explore the ways in which the disorder affects the sufferer’s family and the way the family system can affect OCD symptoms. A phenomenon referred to as “family accommodation” is the tendency for families to respond to a sufferer’s OCD or anxiety by modifying their lifestyles to accommodate the demands made on them by the condition. Family members often enable the sufferer’s symptoms in order to “keep the peace,” but this often causes a significant psychological and practical burden on everyone involved. At Community West we understand that treatment tends to go more smoothly when it is viewed as a family effort. We strive to provide family members with the education and practical tools they need to help the family member in treatment.
Disorders Related to OCD
In the OCD program at Community West we also treat psychiatric disorders that share common features and overlapping symptoms with OCD.These are referred to as Obsessive-Compulsive Related Disorders or OC Spectrum Disorders. Despite the commonalities these conditions share with OCD, it is important to accurately diagnose them because the treatment approach required for each may be different. Sometimes people suffer from OCD as well as one or more of these related disorders:
Body Dysmorphic Disorder (BDD)
Trichotillomania (compulsive hair-pulling)
Excoriation Disorder (compulsive skin picking)
In addition, there is a group of anxiety disorders that respond to exposure and other CBT approaches that are effective for OCD and related disorders. At Community West we treat the following anxiety disorders with cognitive-behavioral interventions:
Social Anxiety Disorder
School Avoidance or Refusal
Separation Anxiety Disorder