Finding a therapist who can diagnose and effectively treat OCD is a challenge to many patients and families. Some estimates indicate that it can take up to 14–17 years from the onset of symptoms, to getting an appropriate diagnosis and effective treatment for OCD.
Why the delay?
- Hiding symptoms. Some people choose to hide their symptoms, often in fear of embarrassment or stigma. This causes many people with OCD to not seek the help of a mental health professional until many years after the onset of symptoms.
- Not enough public awareness of OCD. Until recently, many people did not know there was even a name for their disorder and with no name, they assumed there was no treatment.
- Lack of proper training in health professionals. People with OCD often get the wrong initial diagnosis from health professionals and may wind up seeing many doctors and therapists over the course of several years before finally getting the right diagnosis.
- Difficulty finding local therapists who can effectively treat OCD.
- Not being able to afford proper treatment.
The 2013 APA Practice Guideline for the Treatment of Patients with Obsessive Compulsive Disorder recommends beginning treatment with a type of Cognitive Behavior Therapy (CBT) called Exposure and Response Prevention (ERP), which has the strongest evidence supporting its use in the treatment of OCD. Below are some “tips” and guidelines for finding a good ERP therapist.
Tips for Finding the Right Therapist
When you search for a therapist in the Resource Directory, you may get more than one result for your area. There are many factors to now consider when choosing the right therapist for you. In addition to the practical matters, such as whether they accept your insurance, is their office convenient for you, and so on, you also need to make sure that your new therapist is someone who you will feel comfortable working with. Below are some tips to helping you find the best possible treatment for you!
Remember that some therapists are better at treating OCD than others. It is important to interview therapists to find out if they know how to do Exposure and Response Prevention (ERP) therapy well. Their responses to your questions are a good guide to what you want to know about a new therapist. Your initial consultation may be done over the phone, or in person, but either way, remember:
- You have a perfect right to ask questions. This is your life and health!
- If the therapist is guarded, withholds information, or becomes angry at your requests for information, you should probably look elsewhere.
- If the therapist appreciates how important a decision this is for you and is open friendly and knowledgeable, you may have a gem of a therapist!
- Your relationship with the therapist is important. Especially since they will potentially be asking you to do things that you find uncomfortable as part of your treatment.
Here are some good questions to ask as you consider whether the therapist is a good fit:
- “What techniques do you use to treat OCD?”
If the therapist is vague or does not mention cognitive behavior therapy (CBT) or Exposure and Response Prevention (ERP) use caution.
- “Do you use Exposure and Response Prevention to treat OCD?”
Be cautious of therapists who say they use CBT but won’t be more specific.
- “What is your training and background in treating OCD?”
If they say they went to a CBT psychology graduate program or did a post-doctoral fellowship in CBT, it is a good sign. Another positive is if a therapist says they are a member of the International OCD Foundation (IOCDF) or the Association of Behavioral and Cognitive Therapists (ABCT). Also look for therapists who say they have attended specialized workshops or trainings offered by the IOCDF like the Behavior Therapy Training Institute (BTTI) or Annual OCD Conference.
- “How much of your practice currently involves anxiety disorders?”
A good answer would be over 25%.
- “Do you feel that you have been effective in your treatment of OCD?”
This should be an unqualified “Yes.”
- “What is your attitude towards medication in the treatment of OCD?”
If they are negative about medication this is a bad sign. While not for everyone, medication can be a very effective treatment for OCD.
- “Are you willing to leave your office if needed to do behavior therapy?”
It is sometimes necessary to go out of the office to do effective ERP.
These tips have been adapted from “How to Choose a Behavior Therapist” by Michael Jenike, MD