Autism Spectrum Disorder (ASD) affects approximately 2% of American school-age youth, and its core features – social and communicative deficits, and repetitive and/or stereotyped behaviors – are associated with multidimensional impairment persisting into adulthood. In the roughly 1/3 of youth with ASD who have comorbid obsessive-compulsive disorder (OCD), a synergistic effect is often observed on psychosocial impairment beyond that predicted by a diagnosis of ASD alone. Beyond exacerbation of impairment, there are numerous issues unique to this population which complicate effective assessment and treatment. This panel will present evidence-based modifications to assessment and treatment of individuals with OCD and comorbid ASD.
Many people with OCD suffer from obsessions focused on topics that are rarely shared with others – aggressive impulses, sexual thoughts, and bathroom behavior. However, effective ERP for these symptoms requires both therapist and patient to discuss such topics in detail, and to use this information to maximize treatment. This presentation will discuss topics related to treating taboo symptoms in OCD, including: (1) how to thoroughly assess the functional relationship between obsessions and compulsions, (2) conducting exposures that are appropriate, without being gratuitous, and (3) addressing taboo topics in children with OCD. Unique to this presentation, an OCD sufferer whose symptoms involved taboo content will share the details of his challenging, yet effective, treatment to illustrate these topics.
This workshop will help therapists enhance ERP through capitalizing on recent research in inhibitory learning, and to nurture willingness to engage in exposure-based treatment for OCD. Presenters will address treatment resistance from both Acceptance and Commitment Therapy (ACT) and ERP perspectives. Using didactic and experiential modalities, we will demonstrate for and engage participants in a number of motivational techniques, including the use of mindfulness, defusion, and values interventions, to shape willingness to engage in treatment. We will move beyond understanding to the nuts and bolts of practice. Finally, we will offer consultation to therapists on how best to work with clients or family members who are reluctant to seek and accept help for their OCD.
Research on learning and memory has led to new ways of implementing ERP for OCD that challenge traditional methods. This “inhibitory learning approach” is geared towards maximizing longer-term outcomes and preventing relapse. In our advanced workshop, we will cover strategies derived from this framework that can be applied in the treatment of OCD, including: (a) how and why to promote fear tolerance as opposed to habituation during exposure; (b) the best way to combine cognitive therapy with exposure; (c) the timing and spacing of exposure sessions; and (d) the pros and cons of using an exposure hierarchy. We will include participant interaction, video demonstrations, and adhere to the latest research and conceptual work on exposure and response prevention for OCD.
Our talk will consist of an informative presentation by a forensic psychiatrist on the rights of people with OCD and related disorders under the Americans with Disabilities Act (ADA), and on the options they have based on how severe their OCD may be. We will then discuss the path to implementing those rights at school, college, and the workplace. We will share examples from several people about the hoops they had to endure before these rights were granted, and will present the outcomes of the requests and some helpful tips from lessons learned. Audience members will be encouraged to share their experiences and ask questions.
Interoceptive exposure (IE), wherein clients confront feared body sensations, is a valuable yet underused OCD treatment technique. For some OCD clients, in vivo and imaginal exposures might be insufficient for complete fear extinction and could leave them vulnerable to relapse. The aim of this interactive workshop is to give clinicians another weapon in their therapeutic arsenal against OCD – namely, IE. This presentation will discuss the rationale for using IE to treat OCD, help therapists identify which patients and symptoms are most appropriate for the use of IE, demonstrate the implementation of IE using actual and videotaped illustrations, discuss common therapist concerns and troubleshooting, and facilitate attendee Q&A.
View slides here: http://www.slideshare.net/IOCDF/shannon-blakey-interoceptive-exposure-an-underused-weapon-in-the-arsenal-against-ocd
Though mindfulness can be an invaluable part of treatment, traditional CBT tools, including cognitive restructuring and exposure with response prevention (ERP), are often still the most effective interventions for producing measurable change. So how can we as clinicians enhance these trusted tools with the development of mindfulness skills in our clients? In this talk, therapists treating OCD can develop a comprehensive understanding of the role mindfulness plays within CBT for OCD. Topics will include how to present mindfulness concepts specifically to clients with OCD and related disorders, how to make traditional tools such as the automatic thought record more effective (and less compulsive) by infusing mindfulness principles, and how to promote active engagement in ERP with mindfulness skill development.
View slides here: http://www.slideshare.net/IOCDF/jon-hershfield-applying-mindfulness-to-traditional-cbt-tools-how-to-enhance-what-works-in-terms-your-clients-understand
Getting kids, teens, and parents to actually engage in ERP can present numerous challenges for clinicians. The goal of this talk is to expand therapists’ tool boxes in helping children, teens, and families engage in the ERP work. Four experts who work with the toughest pediatric OCD cases will share their personal tools and tricks that they use to help overcome some of the resistance and challenges that can be inherent in ERP treatment. These strategies will encompass many of the salient domains of exposure work, including pre-planning strategies and tools, actual exposure work and time, post-processing of exposures, and increasing homework compliance and practice outside of therapy time.
The treatment of OCD in patients with Substance Use Disorder (SUD) presents unique challenges for OCD specialty programs and individual therapists treating OCD. Many of the aspects of OCD treatment, including engagement, education, treatment planning, ERP, and medication management, require different approaches for this population. The unique treatment issues related to the treatment for these co-occurring disorders will be addressed with case examples. Strategies provided to attendees will include sample treatment protocols, program development strategies for incorporating evidence informed OCD-SUD treatment into a practice/program, a brief overview of evidence-based treatments for SUD to enhance concurrent treatment outcomes, and other resources for clinicians and patients. Time will be allotted for audience Q&A.
View slides here: http://www.slideshare.net/IOCDF/stacey-conroy-treating-ocd-and-sud-tools-for-effective-treatment
