OCD: Not Just About Handwashing

OCD - Not Just About Handwashing

Obsessive-compulsive disorder (OCD) has been portrayed in the popular media as primarily a problem of checking or washing.

The lay public has accepted OCD as one many people claim, in an ad hoc way, to have given the virtuous qualities associated with it, such as fastidiousness, cleanliness or being well organized. Unfortunately, when individuals actually suffer from this condition, these qualities could not be further from the truth. No one would want to claim they have OCD if they were cognizant of the full range of symptoms.

Most people with OCD suffer greatly and experience incredible emotional pain. Their families struggle with how to best help them. OCD is a severe and debilitating psychological condition affecting 1 percent to 3 percent of the population. The World Health Organization ranks it among the top 10 disabling conditions.

Research suggests it is comprised of subtypes that generally fall in the following categories: symmetry obsessions with symmetry compulsions; obsessions (such as aggressive, sexual, religious or somatic concerns), checking compulsions and contamination obsessions and cleaning compulsions.

Epidemiology research suggests that approximately half of all OCD sufferers report contamination fears associated with washing rituals. Therefore, if you treat individuals with OCD, there is a very high likelihood that the sufferer will have this variant of the disorder.

Many practitioners are aware that the treatment with the greatest level of scientific support for OCD is exposure with response prevention (ERP), which is a component of a broader program of cognitive-behavior therapy (CBT). ERP is said to work through a process of teaching clients that experiencing situations that are avoided do not result in the consequences that they are expecting.

In the case of treating individuals with contamination fears and washing rituals, here are a few helpful tips:

Exposure is Not Harmful

Many therapists are reluctant to practice exposure therapy. The concerns typically involve fears (by the therapist) that the client will drop out, get worse or that the practice will increase the risk of litigation.

Research has shown that dropout among individuals with OCD is comparably high regardless of intervention employed but that ERP is of the highest likelihood in producing good outcome and that clients rarely worsen with its application.

There are no documented cases of litigation to therapists that came about solely due to the application of exposure therapy. This is particularly true in contamination fear with washing rituals, which is one of the most readily treated of the subtypes of OCD.

Emotional Reaction to Exposure is Not Always Fear

The stereotype of OCD sufferers with washing rituals is that they are fearful of contracting an illness. Research over the past 15 years suggests that at least as much of the avoidance in contamination fear is due to much higher disgust reactivity. Many therapists are less familiar with disgust, so here are a few important points to know about this understudied emotion. Disgust is a transmittable emotion

Certain substances and objects lead to disgust reactions. Among the most disgusting things we can encounter are certain body products (i.e., feces, urine, mucus), rotting food and certain types of insects (i.e., spiders) or animals (i.e., rodents). However, experimental findings have shown that disgust operates based on two principles. The first is called the Law of Contagion.

This principle operates when an otherwise neutral object comes in contact with a disgusting object, transferring disgust onto that neutral object. For example, if a clean pen came in contact with mucus, the pen would acquire the disgusting properties. In the case of OCD with washing rituals, the problem is compounded. If that pen were to come in contact with another object such as a cell phone, now the cell phone is also contaminated. This contagion problem can persist across objects multiple times over.

The second principle is a bit less relevant in OCD, called the Law of Similarity. This is when an object that is neutral, but is shaped like a disgusting object leads to a disgust reaction. For example, if one were to serve soup in a bowl shaped like a miniature toilet, this would be evocative of disgust.

Disgust Can Be Treated with Exposure

It may require a bit more intestinal fortitude for the therapist, but ERP for washing rituals where disgust is evoked can still be effective. Be aware that it may take a bit longer than exposure in other circumstances.

When conducting ERP and the primary emotion is fear, there is a consequence that the client is concerned about, but which will not come to pass with the exposure exercise. So the learning is that there is nothing to fear. With disgust, there is typically no consequence except the client offering statements such as “it feels yucky” or “this looks gross.”

These are reactions that are slower to respond to treatment, since it is more a matter of simply getting accustomed to the emotional experience and not recognition of reduced risk. It may be necessary to schedule more frequent sessions in order to ensure a good outcome, such as two or three sessions a week, or longer duration sessions (i.e., up to 90 minutes).

Exposure with response prevention is widely sought out among OCD sufferers. Online forums and professional organizations that have consumer-oriented materials (such as the International Obsessive Compulsive Foundation or the Anxiety and Depression Association of America) have promoted ERP as an empirically supported approach.

As a result providers are often asked to deliver this treatment. In doing so, awareness of the full range of typical emotional reactions that might be provoked is essential for producing better outcomes for clients.

Course excerpt from:

Therapy Tidbits – September/October 2017 is a 1-hour online continuing education (CE) course comprised of select articles from the September/October 2017 issue of The National Psychologist, a private, independent bi-monthly newspaper intended to keep mental health professionals informed about practice issues. Course #11-12 | 2017 | 17 pages | 10 posttest questions

Related Online Continuing Education (CE) Course:

Obsessive-Compulsive Disorder (OCD)Obsessive-Compulsive Disorder (OCD) is a 3-hour online continuing education (CE/CEU) course that reviews the diagnosis, assessment and treatment strategies for OCD.

Obsessive-Compulsive Disorder (OCD) is characterized by intrusive, unwanted, and anxiety-provoking thoughts, images, impulses and rituals that are performed to alleviate the accompanying distress. Because OCD is a heterogeneous disorder with several subtypes, assessing, diagnosing, and treating it can be challenging. Further, the presentation of varying symptoms may be considered to be OC Related Disorders. Being able to make differential diagnoses and treatment recommendations are essential in clinical work with the many patients that present with the spectrum of OC problems. Specific behavioral strategies have been developed and validated in the literature that target the various manifestations of OCD and related disorders.

The first part of the course offers information on the neurobiology, diagnosis and assessment tools, including the various subtypes, and highlights important topics to be taken into consideration during the process. Emotional and cognitive factors are outlined that seem to play important roles in the diagnosis and the course of episodes. The next section is dedicated to describing the clinical factors of and differential aspects of the OC Related Disorders and their prevalence. A case study follows that outlines the precipitating events, assessment, and behavioral treatment of a college student who is struggling to maintain and overcome her OCD. The final section describes effective treatment and coping strategies and augmentations that help to maintain treatment gains. Course #30-95 | 2017 | 60 pages | 20 posttest questions

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This online course provides instant access to the course materials (PDF download) and CE test. After enrolling, click on My Account and scroll down to My Active Courses. From here you’ll see links to download/print the course materials and take the CE test (you can print the test to mark your answers on it while reading the course document).

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Professional Development Resources is approved to sponsor continuing education by the American Psychological Association (APA); the National Board of Certified Counselors (NBCC ACEP #5590); the Association of Social Work Boards (ASWB Provider #1046, ACE Program); the American Occupational Therapy Association (AOTA Provider #3159); the Commission on Dietetic Registration (CDR Provider #PR001); the Alabama State Board of Occupational Therapy; the Florida Boards of Social Work, Mental Health Counseling and Marriage and Family Therapy (#BAP346), Psychology & School Psychology (#50-1635), Dietetics & Nutrition (#50-1635), and Occupational Therapy Practice (#34); the New York State Education Department’s State Board for Mental Health Practitioners as an approved provider of continuing education for licensed mental health counselors (#MHC-0135); the Ohio Counselor, Social Worker & MFT Board (#RCST100501); the South Carolina Board of Professional Counselors & MFTs (#193); the Texas Board of Examiners of Marriage & Family Therapists (#114) and State Board of Social Worker Examiners (#5678); and is CE Broker compliant (all courses are reported within a few days of completion).

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OCD: What Clinicians Need To Know

OCD

Obsessive Compulsive Disorder (OCD) can present in many forms. It can trigger a cascade of behaviors that result in washing, checking, and a variety of routinized behaviors. It can also drive perfectionism and rigidity, as well as intrusive, and disruptive thoughts. Many patients often feel lost, trapped, and without recourse.

And while there can be many factors that contribute to the development of OCD, a fascinating new study done by Kai Schuh from the Institute of Physiology at the Julius-Maximilians-Universität (JMU) Würzburg (Germany) in collaboration with the JMU’s Departments of Psychiatry and Neurology found that one underlying cause may be the absence of the protein SPRED2. In mouse models, Schuh and his team were able to show that without this protein, excessive grooming behavior was triggered (Schuh, 2017).

Occurring in all cells of the body, the protein SPRED2 is found in particularly high concentrations in regions of the brain, namely in the basal ganglia and the amygdala. Normally, the protein inhibits an important signal pathway of the cell, the so-called Ras/ERK-MAP kinase cascade. When it is missing, this signal pathway is more active than usual. When the mice in Schuh’s study were given an inhibitor to attenuate the overactive signal cascade the obsessive-compulsive symptoms improved (Schih, 2017).

This recently discovered link between OCDs and the Ras/ERK-MAP kinase cascade, offers a new way to look at OCD. OCD patients could be responding not just to intrusive thoughts, but an overactive amygdala that results in elevated hypervigilance. Moreover, this study represents just one of the many things we are learning about a diagnosis that has been notoriously hard to identify, and perhaps even harder to treat.

OCD has many subtypes that can often appear similar to many other disorders, such as generalized anxiety, acute stress disorder, PTSD, adjustment disorder, and a variety of phobias, and understanding the etiology as well as the clinical presentation is the foundation of effective treatment. When clinicians use accurate assessment tools to diagnose OCD, as well as its various subtypes, they can then isolate the treatment strategy that will be most helpful to the patient. Further, knowledge of the related emotional, cognitive, and clinical factors that influence the progression of OCD will help clinicians adjust treatment to the patient’s specific needs and augment treatment gains.

While OCD can be difficult to detect and treat – and often the source of much distress for the patients who experience it – through a solid understanding of the most recent research on the etiology and treatment, clinicians can help patients with OCD find ways to live productive, meaningful, and healthy lives.

Related Online Continuing Education (CE) Course:

Obsessive-Compulsive Disorder (OCD)Obsessive-Compulsive Disorder (OCD) is a 3-hour online continuing education (CE/CEU) course that reviews the diagnosis, assessment and treatment strategies for OCD. Obsessive-Compulsive Disorder (OCD) is characterized by intrusive, unwanted, and anxiety-provoking thoughts, images, impulses and rituals that are performed to alleviate the accompanying distress. Because OCD is a heterogeneous disorder with several subtypes, assessing, diagnosing, and treating it can be challenging. Further, the presentation of varying symptoms may be considered to be OC Related Disorders. Being able to make differential diagnoses and treatment recommendations are essential in clinical work with the many patients that present with the spectrum of OC problems. Specific behavioral strategies have been developed and validated in the literature that target the various manifestations of OCD and related disorders. The first part of the course offers information on the neurobiology, diagnosis and assessment tools, including the various subtypes, and highlights important topics to be taken into consideration during the process. Emotional and cognitive factors are outlined that seem to play important roles in the diagnosis and the course of episodes. The next section is dedicated to describing the clinical factors of and differential aspects of the OC Related Disorders and their prevalence. A case study follows that outlines the precipitating events, assessment, and behavioral treatment of a college student who is struggling to maintain and overcome her OCD. The final section describes effective treatment and coping strategies and augmentations that help to maintain treatment gains. Course #30-95 | 2017 | 60 pages | 20 posttest questions

Professional Development Resources is a nonprofit educational corporation 501(c)(3) organized in 1992. We are approved to sponsor continuing education by the American Psychological Association (APA); the National Board of Certified Counselors (NBCC); the Association of Social Work Boards (ASWB); the American Occupational Therapy Association (AOTA); the American Speech-Language-Hearing Association (ASHA); the Commission on Dietetic Registration (CDR); the Alabama State Board of Occupational Therapy; the Florida Boards of Social Work, Mental Health Counseling and Marriage and Family Therapy, Psychology & School Psychology, Dietetics & Nutrition, Speech-Language Pathology and Audiology, and Occupational Therapy Practice; the Ohio Counselor, Social Worker & MFT Board and Board of Speech-Language Pathology and Audiology; the South Carolina Board of Professional Counselors & MFTs; the Texas Board of Examiners of Marriage & Family Therapists and State Board of Social Worker Examiners; and are CE Broker compliant (all courses are reported within a few days of completion).

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Pennsylvania Psychologists Renewal Info

Online Continuing Education (CE) @pdresources.org

Pennsylvania psychologists can save 20% on CE for their upcoming license renewal deadline of November 30, 2017. Up to 15 of the 30 required hours per biennium are allowed from APA-sponsored online CE courses.

CE Required: 30 hours every 2 years
Online CE Allowed: 15 hours (home study)
License Expiration: 11/30, odd years
National Accreditation Accepted: APA
Notes: 3 hours in ethics required each renewal

Pennsylvania psychologists can earn up to 15 hours required for renewal through online courses offered by Professional Development Resources, and save 20% on courses. Click here to view APA-approved online CE courses.

PA Psychologists Save 20% on CE

Professional Development Resources is approved by the American Psychological Association (APA) to sponsor continuing education for psychologists. Professional Development Resources maintains responsibility for all programs and content. Over 100 courses are available!

Suicide Prevention Continuing Education (CE): On July 8, 2016, the governor of Pennsylvania signed into law the Matt Adler Suicide Prevention Continuing Education Act. This legislation requires that licensed psychologists, social workers, marriage and family therapists, and professional counselors seeking to have their licenses renewed complete at least one hour of continuing education in the assessment, treatment, and management of suicide risk. To fulfill the growing requirement for suicide prevention training, Professional Development Resources created a 3-hour online continuing education (CE) course that reviews evidence-based research and offers strategies for screening, assessment, treatment, and prevention of suicide in both adolescents and adults:

Suicide PreventionSuicide Prevention: Evidence-Based Strategies is a 3-hour online continuing education (CE) course that reviews evidence-based research and offers strategies for screening, assessment, treatment, and prevention of suicide in both adolescents and adults. Suicide is one of the leading causes of death in the United States. In 2015, 44,193 people killed themselves. The Centers for Disease Control and Prevention (CDC) notes, “Suicide is a serious but preventable public health problem that can have lasting harmful effects on individuals, families, and communities.” People who attempt suicide but do not die face potentially serious injury or disability, depending on the method used in the attempt. Depression and other mental health issues follow the suicide attempt. Family, friends, and coworkers are negatively affected by suicide. Shock, anger, guilt, and depression arise in the wake of this violent event. Even the community as a whole is affected by the loss of a productive member of society, lost wages not spent at local businesses, and medical costs. The CDC estimates that suicides result in over 44 billion dollars in work loss and medical costs. Prevention is key: reducing risk factors and promoting resilience. This course will provide a review of evidence-based studies so that healthcare professionals are informed on this complex subject. Information from the suicide prevention technical package from the Centers for Disease Control and Prevention will be provided. Included also are strategies for screening and assessment, prevention considerations, methods of treatment, and resources for choosing evidence-based suicide prevention programs. Course #30-97 | 2017 | 60 pages | 20 posttest questions

Online CE Courses for Psychologists:

E-Therapy: Ethics & Best Practices is a 3-hour online continuing education (CE) course that examines the advantages, risks, technical issues, legalities and ethics of providing therapy online. E-therapy can be used to address age-old problems, such as how to reach out to those who might not otherwise avail themselves of psychotherapy services even though they are in acute need. At the same time, it is clear that many providers have embraced the new technologies without a firm grasp on the new and serious vulnerabilities that are introduced when their patients’ personal health information goes online. Included in this course are sections on video therapy, email, text messaging, smart phone use, social media, cloud storage, Skype, and other telecommunications services. This course is focused upon the ethical principles that are called into play with the use of e-therapy. Among them the most obvious concern is for privacy and confidentiality. Yet these are not the only ethical principles that will be challenged by the increasing use of e-therapy. The others include interjurisdictional issues (crossing state lines), informed consent, competence and scope of practice, boundaries and multiple relationships, and record keeping. In addition to outlining potential ethical problems and HIPAA challenges, this course includes recommended resources and sets of specific guidelines and best practices that have been established and published by various professional organizations. Course #30-87 | 2016 | 52 pages | 20 posttest questions

Effects of Digital Media on Children’s Development and Learning is a 3-hour online continuing education (CE/CEU) course that reviews the research on media use and offers guidance for educators and parents to regulate their children’s use of digital devices. Today’s world is filled with smartphones used by people ignoring their surroundings and even texting while driving, which is criminally dangerous. Are there other dangers that may not be as apparent? Media technology (e.g., smart phones, tablets, or laptop computers) have changed the world. Babies and children are affected and research reveals that 46% of children under age one, and up to 59% of eight-year-old children are exposed to cell phones. In England, nearly 80% of senior primary-school staff reportedly are worried about poor social skills or speech problems of children entering school, which they attribute to the use of media devices. Media technology affects family life, children’s readiness for entering school or preschool, and classroom learning. Recent research delineates a developmental progression of understanding information on devices for children between ages 2- 5 years. Younger children may believe false information if it is on a computer. This research is important for understanding technology uses in education. There are also known health risks and possible adverse effects to social-emotional development. Statistics describing the increase of media technology and developing trends in media use are presented along with guidelines and position statements developed to protect children from risks and adverse effects. Course #30-96 | 2017 | 50 pages | 20 posttest questions

Obsessive-Compulsive Disorder (OCD) is a 3-hour online continuing education (CE/CEU) course that reviews the diagnosis, assessment and treatment strategies for OCD. Obsessive-Compulsive Disorder (OCD) is characterized by intrusive, unwanted, and anxiety-provoking thoughts, images, impulses and rituals that are performed to alleviate the accompanying distress. Because OCD is a heterogeneous disorder with several subtypes, assessing, diagnosing, and treating it can be challenging. Further, the presentation of varying symptoms may be considered to be OC Related Disorders. Being able to make differential diagnoses and treatment recommendations are essential in clinical work with the many patients that present with the spectrum of OC problems. Specific behavioral strategies have been developed and validated in the literature that target the various manifestations of OCD and related disorders. The first part of the course offers information on the neurobiology, diagnosis and assessment tools, including the various subtypes, and highlights important topics to be taken into consideration during the process. Emotional and cognitive factors are outlined that seem to play important roles in the diagnosis and the course of episodes. The next section is dedicated to describing the clinical factors of and differential aspects of the OC Related Disorders and their prevalence. A case study follows that outlines the precipitating events, assessment, and behavioral treatment of a college student who is struggling to maintain and overcome her OCD. The final section describes effective treatment and coping strategies and augmentations that help to maintain treatment gains. Course #30-95 | 2017 | 60 pages | 20 posttest questions

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Hoarding Disorder & OCD

Course excerpt from Obsessive-Compulsive Disorder (OCD)

Hoarding DisorderHoarding is the saving, keeping, and accumulation of items that are considered to have some kind of value, even though they might be considered useless, unimportant, and trash to others. Strong emotional attachment, sentimental value, potential usefulness, and fear of running out of supplies (e.g. buying multiples of toilet paper because it’s on sale) are some of the rationalizations for the behavior.

The DSM-5 has classified hoarding as its own diagnosis and is no longer considered an OCD subtype. It is categorized in the Obsessive Compulsive and Related Disorders category of the DSM-5 (American Psychiatric Association, 2013).

Hoarding has received much recent media attention, as evidenced by the TV series Hoarders on the A&E cable channel, PBS documentaries, and memes found on the internet. Parents who have problems with hoarding have been implicated in child neglect and abuse cases, as well as public health task forces being organized due to the impact of hoarding on the home environment. Children on hoarders are usually unable to have play dates at their houses due to the shame and embarrassment of the chaotic household environment.

Hoarding appears to be “hard wired” and ego-syntonic, which makes it a very difficult problem to treat. It typically involves the acquisition of excessive amounts of material goods that may appear valueless or useless. As a result of the hoarding and associated challenges with making decisions about what to keep and what to throw away, the individual often has difficulty with organization. Hoarders have been considered creative due to their ability to think of clever or creative ways of using discarded or useless items, even though they hardly ever do.

Some people have hoarding behaviors not because they want to save items, but because they have problems with disorganization and making decisions about what is important to save or throw away. Junk mail, magazines, and newspaper are common items that pile up and are neglected.

Common dysfunctional thoughts of hoarders are that items with sentimental value should be saved, fear of getting rid of something that he or she might “need” later, belief that almost everything has purpose or value, making decisions about what to save so difficult, that even common items are irreplaceable, not having important or useful information for “later,” and mistakenly discarding important things along with unimportant items.

Commonly hoarded items are newspapers, articles, magazines, books, CDs, clothes, pictures, receipts, mail, emails, post-it notes and slips of paper to read “later,” and collections or sets of favorite things.

Behaviors may include sorting through garbage, saving items to recycle or reuse, taking multiples of freebies (e.g., brochures, samples), and “churning” (moving items around from one pile to the next when trying to organize or sort through items). Extreme distress and a sense of loss of control are experienced if family members attempt to throw things away, and sometimes even when others touch the items.

Some serious negative effects of hoarding can be:

  • Mold/squalor leading to health problems
  • Fires caused by piles of papers kept near the stove
  • Lack of functional living space
  • Injuries sustained when piles of items topple on to someone
  • Public health concerns requiring community intervention
  • Involvement of child services


Current environmental concerns can cause “green guilt” that reinforce hoarding. Reusing and recycling make it difficult for hoarders to throw things away. They may even pick up trash they see while out in public and take it home. Hoarders also do not like to waste and keep things until its last shred of utility.

Cognitive-behavioral therapy is considered the most effective psychotherapy for treating the dysfunctional beliefs and patterns of functioning that contribute to hoarding. Motivational interviewing strategies are also effective in helping to improve insight, which is typically limited in this disorder. Competence, informed consent to treatment, and risk of harm must be considered within the context of any observed neurocognitive deficits.

The prevalence rate of hoarding is between 1.5 and 5% of the general population. The prevalence of co-occurring OCD was 2.9% in a study by Ivanov and colleagues. Another study reported that 96 of 396 hoarders met criteria for OCD.

Click here to learn more.

Obsessive-Compulsive Disorder (OCD)Obsessive-Compulsive Disorder (OCD) is a 3-hour online continuing education (CE/CEU) course that reviews the diagnosis, assessment and treatment strategies for OCD. Obsessive-Compulsive Disorder (OCD) is characterized by intrusive, unwanted, and anxiety-provoking thoughts, images, impulses and rituals that are performed to alleviate the accompanying distress. Because OCD is a heterogeneous disorder with several subtypes, assessing, diagnosing, and treating it can be challenging. Further, the presentation of varying symptoms may be considered to be OC Related Disorders. Being able to make differential diagnoses and treatment recommendations are essential in clinical work with the many patients that present with the spectrum of OC problems. Specific behavioral strategies have been developed and validated in the literature that target the various manifestations of OCD and related disorders. The first part of the course offers information on the neurobiology, diagnosis and assessment tools, including the various subtypes, and highlights important topics to be taken into consideration during the process. Emotional and cognitive factors are outlined that seem to play important roles in the diagnosis and the course of episodes. The next section is dedicated to describing the clinical factors of and differential aspects of the OC Related Disorders and their prevalence. A case study follows that outlines the precipitating events, assessment, and behavioral treatment of a college student who is struggling to maintain and overcome her OCD. The final section describes effective treatment and coping strategies and augmentations that help to maintain treatment gains. Course #30-95 | 2017 | 60 pages | 20 posttest questions

This online course provides instant access to the course materials (PDF download) and CE test. After enrolling, click on My Account and scroll down to My Active Courses. From here you’ll see links to download/print the course materials and take the CE test (you can print the test to mark your answers on it while reading the course document). Successful completion of the online CE test (80% required to pass, 3 chances to take) and course evaluation are required to earn a certificate of completion.


Professional Development Resources
 is approved to sponsor continuing education by the American Psychological Association (APA); the National Board of Certified Counselors (NBCC ACEP #5590); the Association of Social Work Boards (ASWB Provider #1046, ACE Program); the American Occupational Therapy Association (AOTA Provider #3159); the Commission on Dietetic Registration (CDR Provider #PR001); the Alabama State Board of Occupational Therapy; the Florida Boards of Social Work, Mental Health Counseling and Marriage and Family Therapy (#BAP346), Psychology & School Psychology (#50-1635), Dietetics & Nutrition (#50-1635), and Occupational Therapy Practice (#34); the Ohio Counselor, Social Worker & MFT Board (#RCST100501); the South Carolina Board of Professional Counselors & MFTs (#193); and the Texas Board of Examiners of Marriage & Family Therapists (#114) and State Board of Social Worker Examiners (#5678).

What is OCD?

Course excerpt from Obsessive-Compulsive Disorder (OCD)

“What if . . . . . ?” “What if I left the coffee pot on?” “What if I made the wrong decision and someone gets hurt?” Did these thoughts cause your heart to beat a little faster?

Did you go check the coffee pot or let the thought go? Did you change your mind when you doubted the choice you made?

OCDObsessive Compulsive Disorder (OCD) is the doubting disease. The doubts never end. If you are treating a patient with OCD, before you know it, you are caught up in it. You hear the person obsessively analyzing hypothetical and catastrophic outcomes and you are made to think of the infinite minutiae of how germs and safety issues could possibly ruin people’s lives. You may try to reason with his/her irrational thoughts, but it won’t work. The truth is: anything is possible. Germs do cause illness, but those without OCD handle and touch things without a thought about whom else has handled them and what they might have left on them. Even though car accidents happen on a daily basis, we drive ourselves to where we need to go anyway. That is why when you are listening to a person’s symptoms, it is crucial to understand that the content of obsessions is not important. Obsessions can even change from time to time, rendering what seemed to be so urgent then insignificant now. The common denominator of OCD is the doubt.

OCD can be characterized as a glitch in the brain’s frontal cortex, home of executive functioning. The executive function is responsible for cognitive processes such as planning, working memory, attention, making judgments and moral decisions, problem solving, verbal reasoning, inhibition, mental flexibility, task switching, and initiation and monitoring of actions. When functioning under normal circumstances, the brain sends messages to which physiological responses are appropriately activated. With OCD, however, urgent messages are sent under the same circumstances in which nothing is wrong or threatening but compel the person with OCD into action just to make sure. How does this happen?

Neurophysiologically, research shows that during an OCD episode, a specific neurocircuit gets stuck in an obsessive loop. While there is no actual evidence of imminent danger, the person’s orbital frontal cortex kicks into alert, like someone pulling a false fire alarm, which sets a loop in motion that compels him/her to find the fire and put it out. It starts with the cingulate gyrus and transmits to the striatum (caudate nucleus and putamen), then to the globus pallidus, on to the thalamus then back to the frontal cortex. Highly anxious and with a sense of urgency, the person checks all possible places for the fire that isn’t there, which only intensifies the obsessive need to keep checking. The problem is that there is no way to prove a negative. No matter how hard the person tries, there is no way to prove a negative and find something that isn’t there.

Click here to learn more.

Obsessive-Compulsive Disorder (OCD)Obsessive-Compulsive Disorder (OCD) is a 3-hour online continuing education (CE/CEU) course that reviews the diagnosis, assessment and treatment strategies for OCD. Obsessive-Compulsive Disorder (OCD) is characterized by intrusive, unwanted, and anxiety-provoking thoughts, images, impulses and rituals that are performed to alleviate the accompanying distress. Because OCD is a heterogeneous disorder with several subtypes, assessing, diagnosing, and treating it can be challenging. Further, the presentation of varying symptoms may be considered to be OC Related Disorders. Being able to make differential diagnoses and treatment recommendations are essential in clinical work with the many patients that present with the spectrum of OC problems. Specific behavioral strategies have been developed and validated in the literature that target the various manifestations of OCD and related disorders. The first part of the course offers information on the neurobiology, diagnosis and assessment tools, including the various subtypes, and highlights important topics to be taken into consideration during the process. Emotional and cognitive factors are outlined that seem to play important roles in the diagnosis and the course of episodes. The next section is dedicated to describing the clinical factors of and differential aspects of the OC Related Disorders and their prevalence. A case study follows that outlines the precipitating events, assessment, and behavioral treatment of a college student who is struggling to maintain and overcome her OCD. The final section describes effective treatment and coping strategies and augmentations that help to maintain treatment gains. Course #30-95 | 2017 | 60 pages | 20 posttest questions

This online course provides instant access to the course materials (PDF download) and CE test. After enrolling, click on My Account and scroll down to My Active Courses. From here you’ll see links to download/print the course materials and take the CE test (you can print the test to mark your answers on it while reading the course document). Successful completion of the online CE test (80% required to pass, 3 chances to take) and course evaluation are required to earn a certificate of completion. Click here to learn more.

Professional Development Resources is approved to sponsor continuing education by the American Psychological Association (APA); the National Board of Certified Counselors (NBCC ACEP #5590); the Association of Social Work Boards (ASWB Provider #1046, ACE Program); the American Occupational Therapy Association (AOTA Provider #3159); the Commission on Dietetic Registration (CDR Provider #PR001); the Alabama State Board of Occupational Therapy; the Florida Boards of Social Work, Mental Health Counseling and Marriage and Family Therapy (#BAP346), Psychology & School Psychology (#50-1635), Dietetics & Nutrition (#50-1635), and Occupational Therapy Practice (#34); the Ohio Counselor, Social Worker & MFT Board (#RCST100501); the South Carolina Board of Professional Counselors & MFTs (#193); and the Texas Board of Examiners of Marriage & Family Therapists (#114) and State Board of Social Worker Examiners (#5678).

Obsessive-Compulsive Personality Disorder (OCPD)

Course excerpt from Obsessive-Compulsive Disorder (OCD)

OCPDObsessive-Compulsive Personality Disorder differs from OCD in that the symptoms are ego-syntonic. Typically the people surrounding the person with OCPD will be more negatively affected by the disorder than the individual with the disorder.

OCPD is a pattern of behavior or personality that emphasizes orderliness, perfectionism, mental and interpersonal control, and rule following. Individuals with OCPD preoccupy themselves with attention to details, lists, organization, and schedules and experience distress when life intervenes and causes deviation. There may also be rigidity with respect to morality ethics or values that they and others should strictly follow. They strive for perfection in their work and productivity, often to the exclusion of social and leisure activities. Their attention to details and desire for impeccable performance may delay actual completion of tasks. They may have difficulty prioritizing activities because of their need to have everything completed perfectly, and often forego vacations.

The characteristics of OCPD broadly affect the individual’s personality, cognition, affect, interpersonal functioning, and interpersonal control. Although these personality traits may cause distress and impairment, they are stable and not episodic.

OCD and OCPD have similar characteristics and may sometimes be comorbid. Technically, OCPD should be ruled out during an active OCD episode, and then diagnosed when the person is back to their functional baseline. In instances of comorbidity, treatment should focus first on the ego-dystonic symptoms of the OCD in order to better assess the OCPD symptoms.

Motivation for change in people with OCDP is low since they don’t experience distress from their symptoms. Longer term CBT or psychotherapy may be helpful when the person experiences enough negative consequences from their rigid interpersonal and functional style of living.

According to studies on comorbid OCD and OCPD, the range of prevalence falls between 23%–36%.

Obsessive-Compulsive Disorder (OCD)Obsessive-Compulsive Disorder (OCD) is a 3-hour online continuing education (CE/CEU) course that reviews the diagnosis, assessment and treatment strategies for OCD. Obsessive-Compulsive Disorder (OCD) is characterized by intrusive, unwanted, and anxiety-provoking thoughts, images, impulses and rituals that are performed to alleviate the accompanying distress. Because OCD is a heterogeneous disorder with several subtypes, assessing, diagnosing, and treating it can be challenging. Further, the presentation of varying symptoms may be considered to be OC Related Disorders. Being able to make differential diagnoses and treatment recommendations are essential in clinical work with the many patients that present with the spectrum of OC problems. Specific behavioral strategies have been developed and validated in the literature that target the various manifestations of OCD and related disorders. The first part of the course offers information on the neurobiology, diagnosis and assessment tools, including the various subtypes, and highlights important topics to be taken into consideration during the process. Emotional and cognitive factors are outlined that seem to play important roles in the diagnosis and the course of episodes. The next section is dedicated to describing the clinical factors of and differential aspects of the OC Related Disorders and their prevalence. A case study follows that outlines the precipitating events, assessment, and behavioral treatment of a college student who is struggling to maintain and overcome her OCD. The final section describes effective treatment and coping strategies and augmentations that help to maintain treatment gains. Course #30-95 | 2017 | 60 pages | 20 posttest questions

This online course provides instant access to the course materials (PDF download) and CE test. After enrolling, click on My Account and scroll down to My Active Courses. From here you’ll see links to download/print the course materials and take the CE test (you can print the test to mark your answers on it while reading the course document). Successful completion of the online CE test (80% required to pass, 3 chances to take) and course evaluation are required to earn a certificate of completion. Click here to learn more.

About the Author:

Leslie Shapiro, LICSW, has been a Behavior Therapist treating OCD and Related Disorders since 1989 at the OCD Institute since its inception in 1997. She is the author of Understanding OCD: Skills to Control the Conscience and Outsmart Obsessive Compulsive Disorder and has published several peer reviewed articles. She was awarded a McLean Hospital Career Development Grant, which supported her research on guilt aspects of OCD, and published Pathological guilt: A persistent yet overlooked treatment factor in obsessive-compulsive disorder. Ms. Shapiro has lectured extensively on the assessment and treatment of OCD, BDD and family issues, and continues her research on conscience-related factors in OCD. She is a former Peace Corps Volunteer and served in Mali as a health educator from 1982-1984.

CE Information:

Professional Development Resources is approved to offer continuing education by the American Psychological Association (APA); the National Board of Certified Counselors (NBCC ACEP #5590); the Association of Social Work Boards (ASWB Provider #1046, ACE Program); the American Occupational Therapy Association (AOTA Provider #3159); the Commission on Dietetic Registration (CDR Provider #PR001); the Alabama State Board of Occupational Therapy; the Florida Boards of Social Work, Mental Health Counseling and Marriage and Family Therapy (#BAP346), Psychology & School Psychology (#50-1635), Dietetics & Nutrition (#50-1635), and Occupational Therapy Practice (#34); the Ohio Counselor, Social Worker & MFT Board (#RCST100501); the South Carolina Board of Professional Counselors & MFTs (#193); and the Texas Board of Examiners of Marriage & Family Therapists (#114) and State Board of Social Worker Examiners (#5678).

 

 

Obsessive-Compulsive Disorder (OCD) – New CE Course

New Online CE @pdresources.org

Obsessive-Compulsive Disorder (OCD)Obsessive-Compulsive Disorder (OCD) is a new 3-hour online continuing education (CE/CEU) course that reviews the diagnosis, assessment and treatment strategies for OCD.

Obsessive-Compulsive Disorder (OCD) is characterized by intrusive, unwanted, and anxiety-provoking thoughts, images, impulses and rituals that are performed to alleviate the accompanying distress. Because OCD is a heterogeneous disorder with several subtypes, assessing, diagnosing, and treating it can be challenging. Further, the presentation of varying symptoms may be considered to be OC Related Disorders. Being able to make differential diagnoses and treatment recommendations are essential in clinical work with the many patients that present with the spectrum of OC problems. Specific behavioral strategies have been developed and validated in the literature that target the various manifestations of OCD and related disorders.

The first part of the course offers information on the neurobiology, diagnosis and assessment tools, including the various subtypes, and highlights important topics to be taken into consideration during the process. Emotional and cognitive factors are outlined that seem to play important roles in the diagnosis and the course of episodes. The next section is dedicated to describing the clinical factors of and differential aspects of the OC Related Disorders and their prevalence. A case study follows that outlines the precipitating events, assessment, and behavioral treatment of a college student who is struggling to maintain and overcome her OCD. The final section describes effective treatment and coping strategies and augmentations that help to maintain treatment gains. Course #30-95 | 2017 | 60 pages | 20 posttest questions

This online course provides instant access to the course materials (PDF download) and CE test. After enrolling, click on My Account and scroll down to My Active Courses. From here you’ll see links to download/print the course materials and take the CE test (you can print the test to mark your answers on it while reading the course document). Successful completion of the online CE test (80% required to pass, 3 chances to take) and course evaluation are required to earn a certificate of completion. Click here to learn more.
Professional Development Resources is approved to sponsor continuing education by the American Psychological Association (APA); the National Board of Certified Counselors (NBCC ACEP #5590); the Association of Social Work Boards (ASWB Provider #1046, ACE Program); the American Occupational Therapy Association (AOTA Provider #3159); the Commission on Dietetic Registration (CDR Provider #PR001); the Alabama State Board of Occupational Therapy; the Florida Boards of Social Work, Mental Health Counseling and Marriage and Family Therapy (#BAP346), Psychology & School Psychology (#50-1635), Dietetics & Nutrition (#50-1635), and Occupational Therapy Practice (#34); the Ohio Counselor, Social Worker & MFT Board (#RCST100501); the South Carolina Board of Professional Counselors & MFTs (#193); and the Texas Board of Examiners of Marriage & Family Therapists (#114) and State Board of Social Worker Examiners (#5678).
About the Author:
Leslie Shapiro, LICSW, has been a Behavior Therapist treating OCD and Related Disorders since 1989 at the OCD Institute since its inception in 1997. She is the author of Understanding OCD: Skills to Control the Conscience and Outsmart Obsessive Compulsive Disorder and has published several peer reviewed articles. She was awarded a McLean Hospital Career Development Grant, which supported her research on guilt aspects of OCD, and published Pathological guilt: A persistent yet overlooked treatment factor in obsessive-compulsive disorder. Ms. Shapiro has lectured extensively on the assessment and treatment of OCD, BDD and family issues, and continues her research on conscience-related factors in OCD. She is a former Peace Corps Volunteer and served in Mali as a health educator from 1982-1984.