Forms of treatment

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HI Debbie:

Please hang in there, it is tough when you are at the start of seeking out

good OCD help. It took eight months of continuous hunting and going

through more than a dozen docs for us to find the right treatment team for

Steve. Unbelievably they are still all in place since June 1998!

The biggest mistake I kept making was not being fussy enough about who I

took Steve to for therapy. At first I was delighted to just get an

appointment, it took me a long time to get brave enough to be a lot fussier

than that. You are already way ahead of where I was at the beginning.

It sounds like your daughter has hit-and-run OCD. The going back to check

is the ritual. At first we only see the most obvious stuff and as time

passes and we learn more then we start to realize how extensive OCD is.

The first line treatment for OCD in children and adolescents is CBT (which

must include E & RP). Meds are second line for mild to moderate OCD. Often

meds are needed for more severe OCD in kids, often because of complications

with depression. If a treatment provider has not heard about E & RP I would

not bother to see them. I found several professionals who knew about E & RP

but somehow could not progress in giving Steve this kind of therapy, that

is where experience and not just knowledge is important. Usually CBT with

E & RP takes at least 1 hour and preferably 1.5 hours so that habituation to

the exposure can occur and the therapist can track effectiveness of treatment.

It is encouraging if they use the CY-BOCS although some professionals might

think this too research-based an approach. What you can do is administer

it to your daughter as treatment goes along, if they don't, to track

improvement. Actually you can track improvement just by their behavior

just as readily (IMO).

Being your daughter's advocate in finding effective treatment is a hard

job, but the payoff makes it worth it. You will feel uncomfortable and

upset often, but as she gets better you will feel inspired by your struggle.

Good luck, take care, aloha, Kathy (H)

kathyh@...

You wrote:

>>

>>Hi everyone. We just had our first visit with a therapist today. I have

>>some questions, so here goes... My daughter is 16 and is suffering from

>>depression and has OCD obsessive thoughts. While driving she thinks she

>>caused and accident (and sometimes goes back to check) and thinks she may

>>come home and finds her dad and me dead. As far as I know she doesn't

>perform

>>and ritual compulsions and these are the only symptoms I know.

>>Our HMO allows us to see a therapist. Our choices are a Marriage and

Family

>>Child Counselor or a Social Worker. We had the MFCC. We chatted for a few

>>minutes and she asked some questions. When it was time for dad & me to

>>leave, she asked if we had any questions. I asked about her education.

She

>>only told me she's been a therapist for 23 yrs. I asked about her usual

>>methods of treatment. She said medication mostly and some therapy. I

asked

>>what type of therapy and she said " behavioral " . I asked her to be more

>>specific and she said something about thoughts. Wasn't sure what she was

>>talking about, so asked if she meant " stop thinking " and she said " yes,

>>that's one treatment " . It seemed to me she was being very vague when I

>asked

>>her for specific methods of therapy. I asked her if she worked with OCD

>>patients and, of course she said yes. I then asked her if she was familiar

>>with Exposure and Response Prevention and she said she had never heard of

it

>>called that!

>>My question to everyone is...are there other forms of treatment that work

>for

>>OCD (other than E & RP)?

>>Didn't do CY BOCS test. should I be concerned?

>>If she has never heard of E & RP, should I even waste my time with her?

>>In reading their brochure, the initial visit with the therapist is usually

>45

>>min., but subsequent visits are 20-40min. Is that normal, or too short?

>>She said they do " short term therapy " and usually complete in 6 months.

>>Normal?

>>Appointment for psychiatrist is June 2nd. Will try to get medication

sooner

>>from referral nurse. (couldn't even see an M.D.)

>>Anyone with advice as to how we should procede from here?

>>I'm new at this, and HATING it already!

>>Debbie