OK, this is your life and your future. It is also likely to be your money, your time and your hard work . In that case, try and ensure that you pick a therapist who is going to give you a strong chance of making the changes you want to make and achieving the goals you have set.
Here are some guidelines for choosing a therapist;
- Check their credentials. In the UK you are checking for a Diploma, Advanced Diploma, degree, masters or PhD in a cognitive behavioural approach. In the United States, a Masters or PhD is generally considered a minimum requirement.
- There are no OCD-specific qualifications, they will be psychotherapeutic approach specific. In our experience of OCD we only advocate Rational Emotive Behaviour Therapy, Mindfulness, Acceptance and Commitment Therapy and Cognitive Behaviour Therapy* or a combination of two or more of these
- Ask your therapist which approaches they are going to use in your treatment. If you are confused by the answer, ask them to be specific and clear
- Ask what tools they are using to assess your OCD and can they inform you of the diagnosis/results
- Ask how many people your therapist has treated with OCD. Are they a specialist in the OCD field? This is not confidential information and you are entitled to ask.
- Look them up on the internet. Are they part of an OCD community? Have they written articles? Are they affiliated with OCD charities or professional bodies?
- Ask if they have any testimonials? Are there reviews of their work on the internet?
- If your therapist tells you they can cure OCD, they are not the right therapist. Period.
- OCD is a chronic condition, however, the treatment should not be open-ended. Ask your therapist for a projected treatment timescale (100% accuracy is not realistic and more complicated issues may occur but you should be informed of this development at the time)
- Our guidelines for initial crisis management of OCD are 8-10 sessions for mild OCD, 10-15 for moderate OCD and 15+ for acute cases.
- Following initial crisis management, ask the therapist what follow-up programme they have in place? There should be a specific, structured follow up that you can both understand and see the potential for benefit. E.g. we have a 9 week and 10 month follow up programme depending upon individuals
What to look out for when you are in therapy (for OCD);
- What supporting materials and information sheets do they offer? OCD treatment is a learning and tools-based approach. The core work is done in the time between sessions when you practice the skills you have learnt. Supporting materials are helpful and can cover gaps for those parts of the session that you don’t remember (a client typically absorbs only 15% of any session).
- Sessions should be a combination of reviewing homework set the previous session, discussing progress, discussing coping skills and setting new homework
- Check that your therapist is practicing cognitive behavioural and acceptance-based approaches if you find that your sessions focus heavily on your history, general chit chat about how your week has been or in convincing you that your OCD fears won’t happen
- Expect to see progress! Yes, that’s right. Not in terms which cannot be measured, e.g., being happy, but in terms of achieving realistic, achievable, measurable goals, e.g., reducing compulsions to a discussed level, returning to work, showering for just 10 minutes, once a day, driving to work alone, etc. etc.
- OCD is a chronic, lifespan condition. Is there a structured follow up plan? One that is convenient for you?
- Does the therapist offer flexible formats? Some people with OCD have issues around their immediate environment. Is the therapist prepared to work in your environment, assuming it is safe for them to do so? Some people with OCD cannot leave their homes. Is the therapist prepared to offer telephone sessions, at least in the beginning so that the client can work towards getting out of the house?
- How much emphasis does the therapist place upon setting guidelines for your family, friends or carers? Do they realize that collusion can play a highly significant part in your recovery? Do they have facilities or offer treatment (with therapists other than themselves) for the people around you?
- Is the therapist prepared to be “hands on”? OCD commonly manifests as severely dysfunctional behaviour patterns. Is the therapist prepared to show you what to do, do it with you? Are they prepared to leave their office and show you how to help yourself in the situations which cause you problems?
*we fully support the scientific evidence behind the behavioural component of CBT but make sure that your therapist also knows how to work on your cognitions (thought processes) too.