Here’s How to Handle Your Therapist Not Knowing ERP
Therapy is an effective way to treat obsessive-compulsive disorder (OCD), but not every type of therapy is beneficial for OCD. In fact, some types of therapy can be counterproductive to treating the condition. When it comes to OCD, the right type of therapy is crucial for proper treatment. How do you make sure your therapist is properly trained in treating OCD? And what should you do if your therapy isn’t working? In this article, we’ll discuss what you need to know to make sure you receive the best treatment for OCD.
Exposure and response prevention (ERP) therapy is considered the gold standard for OCD. This treatment specifically targets your obsessions and compulsions. During ERP therapy, you will review with your therapist the thoughts or scenarios that are causing you the most anxiety, and then work to come up with a specialized treatment plan to face them through gradual, controlled exposure.Other types of therapy may help a patient with OCD feel better in the short term, but ERP therapy has a proven track record of effectively treating OCD in the long term. It has been found effective for 80% of OCD patients, and the majority experience results within 12-20 sessions. If your therapist does not know ERP therapy, it may be best to speak to them about your concerns and how to connect with an ERP-trained therapist.
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What types of therapy can be counterproductive for OCD?
Talk therapy and cognitive behavioral therapy (CBT) are two very common types of treatment you are likely to encounter when conducting a general search for therapists. Some therapists may say they treat OCD with cognitive therapy (a type of CBT), eye movement desensitization and reprocessing (EMDR) or other forms of treatment. While these treatments can be very helpful for other mental health conditions, they can be problematic for treating OCD. Here are the common ones you may encounter while searching for therapy for OCD, and why they are not the best solution for most OCD patients:
Talk therapy is a treatment based on speaking with a therapist about your past experiences, stressful thoughts and traumas. This can be a very effective form of treatment for depression and anxiety and other mental health conditions. When it comes to OCD, however, talk therapy is not considered effective. Patients with OCD may find that analyzing their anxieties in detail and trying to come up with solutions or explanations only increases the severity of their obsessions and compulsions.
CBT, another common form of therapy, is an umbrella term to describe multiple types of treatment like cognitive therapy that are based on providing a patient with practical tools to improve their mental health. During CBT, a patient will examine the core beliefs driving their everyday behaviors. A patient may learn breathing techniques they can use to relieve anxiety. They may work with a therapist to come up with ways to self-soothe, such as phrases to repeat to themselves during times of elevated stress. CBT can be very helpful for treating anxiety, depression, eating disorders and other conditions. But like talk therapy, there are ways CBT can be counterproductive for people with OCD and even reinforce the obsessive-compulsive cycle. For example, repeating a soothing statement could easily become a compulsion for someone with OCD. This will provide temporary relief, but not address the cause of obsessions and compulsions. While some people with OCD find some degree of relief from these therapies, they usually do not find long-term success, as the root cause of their distress is not being addressed.EMDR is a relatively new form of nontraditional psychotherapy that has been growing in popularity. It is primarily intended to treat post-traumatic stress disorder (PTSD). During treatment, a patient will be asked to direct their eyes towards a therapist’s hands while recalling disturbing past events. While this form of treatment may be helpful for people with OCD who also have past experiences of trauma, it is not recommended as primary treatment for OCD. Being asked to go into detail about past events can further increase a patient’s obsessions and compulsions and may be a form of compulsion itself if not based in trauma.
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Should I switch to an ERP therapist?
It takes courage to seek treatment of any kind, and it can be incredibly frustrating to feel like you’re not making the progress in therapy you want to be. If you have been in your current form of therapy for 20 sessions and have not seen your OCD symptoms improve, it might be time to consider switching to ERP therapy.
Of course, switching therapists isn’t fun, especially if you’ve already established a bond with your current provider. However, it’s important to remember that effective treatment for OCD is very specific. Without direct exposure to your obsessions and intentional prevention of your compulsions, they are unlikely to go away on their own.
OCD can take many different forms and touch on a variety of themes, many of them taboo, and it’s important that a mental health professional is trained to effectively treat the different subtypes of OCD. This could otherwise lead to misdiagnosis. For example, someone with harm OCD will experience ongoing anxiety about not wanting to harm themselves or another person. If a therapist is not trained in OCD, they may characterize the patient as someone in danger of causing harm rather than a person experiencing OCD. Unfortunately, we are well aware that sometimes people encounter several therapists who are not familiar with the specific OCD subtype they are experiencing before finding the right treatment. Though it isn’t easy to continue to seek proper treatment, a mental health professional who is trained in OCD and ERP will be able to properly treat your condition.
If you’re interested in learning more about ERP, you can schedule a free call with the NOCD clinical team to find out how this type of treatment can help you. All of our therapists specialize in OCD and receive ERP-specific training and ongoing guidance from our clinical leadership team. Many of them have dealt with OCD themselves and understand how crucial ERP therapy is.
Keara E. Valentine, Psy.D., is a postdoctoral fellow at Stanford University School of Medicine in the OCD and Related Disorders Track, where she specializes in the assessment and treatment of OCD and related disorders. Dr. Valentine utilizes behavioral-based therapies including Cognitive Behavioral Therapy (CBT) and Exposure and Response Prevention (ERP) with children, adolescents, and adults experiencing anxiety-related disorders.
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NOCD Therapists specialize in treating OCDView all therapists
Licensed Therapist, MA
I started as a therapist over 14 years ago, working in different mental health environments. Many people with OCD that weren't being treated for it crossed my path and weren't getting better. I decided that I wanted to help people with OCD, so I became an OCD therapist, and eventually, a clinical supervisor. I treated people using Exposure and Response Prevention (ERP) and saw people get better day in and day out. I continue to use ERP because nothing is more effective in treating OCD.
Licensed Therapist, LCMHC
When I started treating OCD, I quickly realized how much this type of work means to me because I had to learn how to be okay with discomfort and uncertainty myself. I’ve been practicing as a licensed therapist since 2016. My graduate work is in mental health counseling, and I use Exposure and Response Prevention (ERP) therapy because it’s the gold standard of OCD treatment.
Licensed Therapist, MA
I have personally struggled with OCD and know what it's like to feel controlled by intrusive thoughts and compulsions, and to also overcome it using the proper therapy. I’ve been a licensed therapist since 2017. I have an M.A. in Clinical Mental Health Counseling, and practice Exposure and Response Prevention (ERP) therapy. I know by experience how effective ERP is in treating OCD symptoms.