Guest guest Posted April 15, 2012 Report Share Posted April 15, 2012 For clothing issues, the ERP is pretty easy. Set aside a time of day that you dont have anything else to do( that is the hard part). Give yourself about an hour. Then explain to the child that you want them to put on the offending item ( start with something that is more mildly bothersome and progress over weeks to something that is more bothersome) and wear it, noticing how uncomfortable it makes them. Make a little anxiety or uncomfortable chart with pre task, 1 min, 3 min, 5 min, 10 min , 15 min, 20 min. Tel them you want them to rank their anxiety 0-10 with 10 being unbearable. Let them know that over time they will get less uncomfortable( I used the analogy of a hot bath or seeing in the dark- the longer you do it the less uncomfortable it is because your body adjusts). Let them know that this is just an exercise, they dont have to wear it all day, and if they are uncomfortable to get them to focus on that , dont try to distract themselves. The goal is for them to wear the item until their anxiety goes up high, then comes down to almost nothing or at least more than half of the height of the anxiety (which it will do naturally). If they know it is an exercise and they dont have to endure it all day and they dont have to function, and they can cry and break down or whatever AND that there is a prize at the end ( work out something that motivates them- for us it was TV or video game time which we usually restrict- we did minute for minute ERP for video time ). Do this daily or twice daily with the same item of clothing until that item no longer raises an issue for them. Then move to a harder item and repeat. Once things start to extinguish, it tends to generalize ,so you dont have to do EVERY item in the whole world. Similar exercises work for really any physical compulsion. Some therapists have told me to set a timer and to the exercise for a set number of minutes, but that is not as good because the treatment is for them to see that EVENTUALLY ( usually within about 20 min) the anxiety WILL decrease. If you end the exercise BEFORE that happens, then you just reinforce the fear, and the anxiety decrease does not happen at a predictable interval. The goal is for the exercise to become easy and boring over time and for them to have a sense of mastery. The mental compulsions are a bit harder to work with. Good luck Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 15, 2012 Report Share Posted April 15, 2012 Thanks for taking time to write this - so clear and plain. I wish I could have given it to my therapist before we ever started. Rhonda Re: - ERP For clothing issues, the ERP is pretty easy. Set aside a time of day that you dont have anything else to do( that is the hard part). Give yourself about an hour. Then explain to the child that you want them to put on the offending item ( start with something that is more mildly bothersome and progress over weeks to something that is more bothersome) and wear it, noticing how uncomfortable it makes them. Make a little anxiety or uncomfortable chart with pre task, 1 min, 3 min, 5 min, 10 min , 15 min, 20 min. Tel them you want them to rank their anxiety 0-10 with 10 being unbearable. Let them know that over time they will get less uncomfortable( I used the analogy of a hot bath or seeing in the dark- the longer you do it the less uncomfortable it is because your body adjusts). Let them know that this is just an exercise, they dont have to wear it all day, and if they are uncomfortable to get them to focus on that , dont try to distract themselves. The goal is for them to wear the item until their anxiety goes up high, then comes down to almost nothing or at least more than half of the height of the anxiety (which it will do naturally). If they know it is an exercise and they dont have to endure it all day and they dont have to function, and they can cry and break down or whatever AND that there is a prize at the end ( work out something that motivates them- for us it was TV or video game time which we usually restrict- we did minute for minute ERP for video time ). Do this daily or twice daily with the same item of clothing until that item no longer raises an issue for them. Then move to a harder item and repeat. Once things start to extinguish, it tends to generalize ,so you dont have to do EVERY item in the whole world. Similar exercises work for really any physical compulsion. Some therapists have told me to set a timer and to the exercise for a set number of minutes, but that is not as good because the treatment is for them to see that EVENTUALLY ( usually within about 20 min) the anxiety WILL decrease. If you end the exercise BEFORE that happens, then you just reinforce the fear, and the anxiety decrease does not happen at a predictable interval. The goal is for the exercise to become easy and boring over time and for them to have a sense of mastery. The mental compulsions are a bit harder to work with. Good luck Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 15, 2012 Report Share Posted April 15, 2012 Thanks for taking time to write this - so clear and plain. I wish I could have given it to my therapist before we ever started. Rhonda Re: - ERP For clothing issues, the ERP is pretty easy. Set aside a time of day that you dont have anything else to do( that is the hard part). Give yourself about an hour. Then explain to the child that you want them to put on the offending item ( start with something that is more mildly bothersome and progress over weeks to something that is more bothersome) and wear it, noticing how uncomfortable it makes them. Make a little anxiety or uncomfortable chart with pre task, 1 min, 3 min, 5 min, 10 min , 15 min, 20 min. Tel them you want them to rank their anxiety 0-10 with 10 being unbearable. Let them know that over time they will get less uncomfortable( I used the analogy of a hot bath or seeing in the dark- the longer you do it the less uncomfortable it is because your body adjusts). Let them know that this is just an exercise, they dont have to wear it all day, and if they are uncomfortable to get them to focus on that , dont try to distract themselves. The goal is for them to wear the item until their anxiety goes up high, then comes down to almost nothing or at least more than half of the height of the anxiety (which it will do naturally). If they know it is an exercise and they dont have to endure it all day and they dont have to function, and they can cry and break down or whatever AND that there is a prize at the end ( work out something that motivates them- for us it was TV or video game time which we usually restrict- we did minute for minute ERP for video time ). Do this daily or twice daily with the same item of clothing until that item no longer raises an issue for them. Then move to a harder item and repeat. Once things start to extinguish, it tends to generalize ,so you dont have to do EVERY item in the whole world. Similar exercises work for really any physical compulsion. Some therapists have told me to set a timer and to the exercise for a set number of minutes, but that is not as good because the treatment is for them to see that EVENTUALLY ( usually within about 20 min) the anxiety WILL decrease. If you end the exercise BEFORE that happens, then you just reinforce the fear, and the anxiety decrease does not happen at a predictable interval. The goal is for the exercise to become easy and boring over time and for them to have a sense of mastery. The mental compulsions are a bit harder to work with. Good luck Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 15, 2012 Report Share Posted April 15, 2012 Thanks for taking time to write this - so clear and plain. I wish I could have given it to my therapist before we ever started. Rhonda Re: - ERP For clothing issues, the ERP is pretty easy. Set aside a time of day that you dont have anything else to do( that is the hard part). Give yourself about an hour. Then explain to the child that you want them to put on the offending item ( start with something that is more mildly bothersome and progress over weeks to something that is more bothersome) and wear it, noticing how uncomfortable it makes them. Make a little anxiety or uncomfortable chart with pre task, 1 min, 3 min, 5 min, 10 min , 15 min, 20 min. Tel them you want them to rank their anxiety 0-10 with 10 being unbearable. Let them know that over time they will get less uncomfortable( I used the analogy of a hot bath or seeing in the dark- the longer you do it the less uncomfortable it is because your body adjusts). Let them know that this is just an exercise, they dont have to wear it all day, and if they are uncomfortable to get them to focus on that , dont try to distract themselves. The goal is for them to wear the item until their anxiety goes up high, then comes down to almost nothing or at least more than half of the height of the anxiety (which it will do naturally). If they know it is an exercise and they dont have to endure it all day and they dont have to function, and they can cry and break down or whatever AND that there is a prize at the end ( work out something that motivates them- for us it was TV or video game time which we usually restrict- we did minute for minute ERP for video time ). Do this daily or twice daily with the same item of clothing until that item no longer raises an issue for them. Then move to a harder item and repeat. Once things start to extinguish, it tends to generalize ,so you dont have to do EVERY item in the whole world. Similar exercises work for really any physical compulsion. Some therapists have told me to set a timer and to the exercise for a set number of minutes, but that is not as good because the treatment is for them to see that EVENTUALLY ( usually within about 20 min) the anxiety WILL decrease. If you end the exercise BEFORE that happens, then you just reinforce the fear, and the anxiety decrease does not happen at a predictable interval. The goal is for the exercise to become easy and boring over time and for them to have a sense of mastery. The mental compulsions are a bit harder to work with. Good luck Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 16, 2012 Report Share Posted April 16, 2012 So we need to develop a new category of ERP specialists - moms who have " been there, done that. " I expect they would be a little less pricey than $100-200/hour and as with my therapist, would not totally fail. I would love to pay you to work with my son. It's kind of like the on-line places where you can get glasses for 10% of the cost of the doctor's office. Hopefully it's just a matter of time until some moms step up and start offering this to so many of us who are desperate to find and afford effective help. Rhonda Re: - ERP I think many of us feel we could BE therapists at this point in life . I am likely the best CBT/ ERP person in VT and I am not a therapist! Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 16, 2012 Report Share Posted April 16, 2012 So we need to develop a new category of ERP specialists - moms who have " been there, done that. " I expect they would be a little less pricey than $100-200/hour and as with my therapist, would not totally fail. I would love to pay you to work with my son. It's kind of like the on-line places where you can get glasses for 10% of the cost of the doctor's office. Hopefully it's just a matter of time until some moms step up and start offering this to so many of us who are desperate to find and afford effective help. Rhonda Re: - ERP I think many of us feel we could BE therapists at this point in life . I am likely the best CBT/ ERP person in VT and I am not a therapist! Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 16, 2012 Report Share Posted April 16, 2012 So we need to develop a new category of ERP specialists - moms who have " been there, done that. " I expect they would be a little less pricey than $100-200/hour and as with my therapist, would not totally fail. I would love to pay you to work with my son. It's kind of like the on-line places where you can get glasses for 10% of the cost of the doctor's office. Hopefully it's just a matter of time until some moms step up and start offering this to so many of us who are desperate to find and afford effective help. Rhonda Re: - ERP I think many of us feel we could BE therapists at this point in life . I am likely the best CBT/ ERP person in VT and I am not a therapist! Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 16, 2012 Report Share Posted April 16, 2012 Hello, I think you have a great idea. There is so much expertise that has been gained by those of us who have been through ERP. In a way, it's a shame not to have all that knowledge be available to those who need it. Like many who have OCD, I couldn't find a good OCD therapist nearby and had to find ways to help my son on my own. Through a lot of trial and error, we finally figured out how to deal with OCD - so why not help others and keep them from making the same mistakes we did? Best, Joni > > I have struggled with severe OCD, and my children both have it. My mother was an amazing help with exposures, and I do the same with my kids. Since I have always been very concerned that there are many out there who need ERP/CBT, but can't afford the $250 it is by us, I have truly wanted to start a program through the OC Foundation to have volunteers help others with ERP. I am not suggesting that laypeople create the therapy protocol, but once someone has been seen by a professional, I strongly believe that a layperson could be a wonderful helper in the process, allowing such treatment for so many more than could avail themselves of it otherwise. > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 16, 2012 Report Share Posted April 16, 2012 Hey, once the moms of this country get going, they're unstoppable! That's what's created the homeschool movement. What made that movement successful was moms banding together to provide services for their own kids - at least that's where I've seen the movement really work. The same could be done through parent support groups for OCD. There's one within 1 1/2 hours of where I live. When my son is ready to do ERP again, I'm going to attend and ask someone who's " been there " to help me out, and I'll pay them. If you want to help others in your area, why not put an ad in the paper to form a support group for OCD parents. Then you can offer your services as a coach to their existing treatment. I would definitely go for that if I had access to someone who offered it. Rhonda Re: - ERP Hello, I think you have a great idea. There is so much expertise that has been gained by those of us who have been through ERP. In a way, it's a shame not to have all that knowledge be available to those who need it. Like many who have OCD, I couldn't find a good OCD therapist nearby and had to find ways to help my son on my own. Through a lot of trial and error, we finally figured out how to deal with OCD - so why not help others and keep them from making the same mistakes we did? Best, Joni > > I have struggled with severe OCD, and my children both have it. My mother was an amazing help with exposures, and I do the same with my kids. Since I have always been very concerned that there are many out there who need ERP/CBT, but can't afford the $250 it is by us, I have truly wanted to start a program through the OC Foundation to have volunteers help others with ERP. I am not suggesting that laypeople create the therapy protocol, but once someone has been seen by a professional, I strongly believe that a layperson could be a wonderful helper in the process, allowing such treatment for so many more than could avail themselves of it otherwise. > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 16, 2012 Report Share Posted April 16, 2012 Great idea and so needed!! Quote Link to comment Share on other sites More sharing options...
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