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?
Obsessive 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.
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).