My Approach
The research on OCD is clear – effective treatment requires a structured approach. Simply talking about obsessions and compulsions is unlikely to lead to improvements. Neither is talking about one’s past. It’s probably most accurate to think of me as a coach helping you develop new skills. Together, we’ll identify all the tricks of your OCD. I’ll then help you learn and practice skills to challenge your OCD.
Exposure and Response (or Ritual) Prevention
The treatment for OCD with the greatest research support is called Exposure and Response (or Ritual) Prevention—or ERP for short. With ERP, the therapist and client collaboratively come up with exercises in which the client learns to confront obsessions without performing rituals. This process is done step-by-step: less scary situations or obsessions are approached first. This helps “starve” the OCD of its power, and teach clients they can face whatever fears their OCD comes up with. Eventually, we work up to the hardest obsessions and compulsions.
The research on OCD is clear – effective treatment requires a structured approach.
Acceptance and Commitment Therapy
There’s also a newer treatment for OCD based on a cognitive behavioral approach called Acceptance and Commitment Therapy (ACT, said as one word “act”). In ACT, treatment focuses more broadly on learning to how make space for uncomfortable inner experiences such as thoughts, feelings, and bodily sensation, and to take action towards what’s most important to us.
ACT-Enhanced ERP for OCD
In my own work, I may begin with ERP—particularly if the individual has successfully done ERP in the past. For many people, however, I’ve found it helpful to begin with 4-5 sessions of ACT before transitioning into ERP. I have found that ACT helps to prepare people for the work of ERP, as ACT skills training provide people a means to practice mindfully observing obsessive thoughts and learning to experience discomfort before moving into more intense ERP work.
There are a number of research studies that have found that even a brief ACT interventions help people be more open to doing something uncomfortable (and helpful) such ERP. Many clients who are very scared of ERP in the beginning of treatment are more open to it after a few sessions of ACT.
Additionally, many clients have commented that ACT helps them develop skills for managing non-OCD-related anxiety and for living their lives as whole. ACT is about learning to let go of the struggle inside ourselves and to take action towards meaningful directions. The goal is to take back your life from OCD, live better, and do the things that are most important to you!
I’ve studied both the ERP and the ACT literature, and I’ve talked to expert clinicians and researchers in order to combine these approaches in a cohesive, consistent, and flexible manner. I have connections with local and international experts in the treatment of OCD and consult with them regularly to make sure I am offering the best treatment possible. I’m always tinkering with my approach to offer the most flexible and effective treatment I can. I’ve even develop my own research studies combining these approaches to better understand the processes involved, and I’m always tinkering with my approach to offer the most flexible and effective treatment I can.