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Originally obsessive-compulsive disorder was considered extremely difficult, if not impossible, to treat. Psychoanalytic thought, based on Freud's theories of unconscious drives and wishes, produced many theories and interesting case studies, but no treatment approaches that could be proven effective. Cognitive-behavioral researchers tested a number of techniques that have since been refined into what is now called exposure and ritual prevention (abbreviated as ERP or EX/RP) — an effective psychological strategy for the treatment of OCD.
The OCD treatment program used by therapists at the Louisville OCD Clinic includes a comprehensive evaluation, approximately 17 treatment sessions, 1-2 family sessions (if indicated), and 2 follow-up sessions. These sessions include psychoeducation, treatment planning, exposure and ritual prevention activities, relapse prevention training, and home visits, as needed. Treatment is offered for children and adults.
The comprehensive evaluation is 2-3 hours, but may be completed in 2 shorter sessions. Treatment sessions are typically delivered in two 60-90 minute (double) sessions per week. For people coming from out of town, intensive treatment is offered, which is generally 2 daily 90-minute sessions over a 1-2 week period, followed by twice weekly videoconference sessions [more about our intensive program]. Family sessions are 45 minutes. Follow-up sessions are 30 minutes. Also clients should anticipate 1-2 hours of homework each day. Most sessions are in person, but some sessions can be by phone or videoconference as-needed. For out-of-town clients, complete treatment by videoconference may be an option. A group for adults with OCD is offered, and all clients are encouraged to attend.
Once the treatment program is complete, most clients will no longer require treatment beyond the 2 follow-up sessions. However, some clients will require periodic booster sessions for new OCD issues that arise. Clients with the most severe OCD or with complicated conditions will require ongoing treatment to maintain gains, such as weekly or twice-monthly 45-minute sessions.
We also offer treatment for related disorders, such as hoarding disorder (excessive acquiring/saving), body dysmorphic disorder (syndrome of imagined ugliness), phobias, health/illness anxiety (hypochondria), compulsive hair pulling, and eating disorders.
There is no cure for OCD, but 80% of clients can expect a major reduction in symptoms. Generally, those who attend sessions and do the homework will make great improvements, and those who do not follow the program will experience less improvement. For most people, this type of treatment is more effective than medication for OCD. However, some people will require both medication and the treatment program for maximum results.
Sometimes people with OCD get frustrated because their OCD is not improving, despite many hours of therapy. Although any medical doctor can take your blood pressure, only a few can do heart surgery. Likewise, any therapist can help someone who is feeling a bit blue, but only a few can effectively treat OCD. OCD requires a specialized treatment called Exposure and Ritual Prevention (ERP or EX/RP) that only a few therapists have training to deliver. Read more about the common mistakes therapists make when treating OCD.
The following references describe Exposure and Ritual Prevention as the treatment of choice for OCD: