GETTING PROPER CBT TREATMENT FOR OCD AND BFRBs

By Fred Penzel, Ph.D.

Whenever you get the name of a behavioral therapist or psychiatrist, whatever the source, be sure to check out the practitioner's credentials and level of knowledge and experience. Don't be afraid to conduct a mini-interview with them when you call. You have the right to assertively question their ability to help you. Be sure to ask the following types of questions when you call the practitioner:

1. "What degrees do you hold and are you state licensed?" (Avoid the unlicensed as they are unregulated, uninsured, and you will have no protection if you feel you have not been treated properly.)

2. "Do you specialize in OCD (or Body Dysmorphic Disorder, Trichotillomania, Compulsive Skin Picking, or Compulsive Nail Biting as the case may be)? What are your qualifications, and have you had any special supervised training in the treatment of my disorder?"

3. "How long have you been in practice? How many cases of my disorder have you treated? What percentage of your cases have been adults vs. children. How many cases of this are you currently treating?"

4. "What is your orientation?" (Ask this question only if you are calling about getting therapy, not medication. The correct answer should be 'behavioral' or 'cognitive/behavioral.')

5. "Do you endorse the use of behavioral therapy together with medication?" (Ask this if you are calling a psychiatrist. The correct answer should be "Yes.")

6. "Do you endorse the use of medication (if necessary) together with behavioral therapy? (Ask this if you are calling a behavioral therapist. The correct answer should be "Yes.")

7. What techniques do you use to treat disorders such as mine? (Ask this if you are calling about cognitive/behavioon for OCD and BDD, and Habit Reversal Training as well as Comprehensive Behavioral Therapy for TTM, skin picking and nail biting. (A therapist who uses these techniques is probably trained in cognitive therapy as well, but ask if they have training in this approach anyway.)

8. What is your fee? Are your services covered by insurance (if this is an important factor in affording therapy)? Note: Check your own insurance coverage before you call to make sure you are covered for outpatient mental health services. Also findout about how much coverage you have.

9. How often would you have to see me? (Once per week is about average, unless you are looking into intensive short-term therapy for OCD or BDD).

10. On the average, how long does the treatment take? (This may be a difficult question to answer if there are other problems to be solved in addition to an OC disorder)

If you are not happy about the answers you are getting, or if the person you are talking to is being evasive, don't hesitate to go elsewhere. Keep trying until you find someone you feel comfortable with. In any case, be persistent and don't give up.

If you would like to read more about what Dr. Penzel has to say about OCD and related problems, take a look at his self-help book, "Obsessive-Compulsive Disorders: A Complete Guide to Getting Well and Staying Well," (Oxford University Press, 2000). You can learn more about it at www.ocdbook.com