Clinical Psychology OCD treatment and approaches

Obsessive-Compulsive Disorder (OCD) has a cognitive-behavioral component that includes a distortion of an individual's environment. OCD has similar components to many anxiety disorders. Anxiety is a result of a disrupted and dysfunctional thought patterns. Anxiety produces adverse reactions affecting the nervous system and an overload of stimulation. Research suggests a genetic predisposition and hormonal malfunction can contribute to an individual’s suffering from OCD. The obsessions of OCD are impulses an individual cannot control.

The individual affected by OCD feels the only relief from the compulsions is to complete the rituals to relieve the anxiety.

The behavioral components associated with obsessive thoughts and impulses produce ritualistic practices. The emotional components from a psychodynamic perspective have possible implications from early childhood with negative feelings associated with the relationships with his or her parents. Psychologists suggest the underlying condition later evolve into an OCD diagnosis (Hansell & Damour, 2008). There are four major approaches for the treatment of obsessive-compulsive disorder (OCD).

Cognitive-behavioral, humanistic, family systems, and psychodynamic approaches are the four major therapy treatments.

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These approaches have different perceptions of methods for management. Each approach understands obsessive compulsive disorder as a disorder where an individual exhibits undesirable repetitive and anxiety producing behaviors and emotions followed by a compulsive behavior of repetitive rituals. The individuals affected by OCD believe the anxiety will be reduced by performing the ritual (Hansell & Damour, 2008).

Cognitive-behavioral theory establishes the negative behaviors associated to an individual’s environment with positive or negative reinforcements and consequences for the actions. The individuals suffering from OCD respond and adjust to his or her behaviors associated with interaction received in his or her environment.

Cognitive-behavioral theory with OCD associates the compulsive behavior of rituals that provide perceived relief from anxiety as produced by disturbing thoughts and impulses (Hansell & Damour, 2009). The approach facilitates a decrease and reduction in the anxiety as it associates with the reinforcement of the rituals.

The cognitive behavioral approach focuses on changes in the way an individual responds to the stressor, changing the ritualistic response to the disturbing thoughts. The individual is asked to think about something disturbing to become anxious and not practice the usual ritualistic behavior as part of treatment (Cottraux, Yao, Lafont, Mollard, Bouvard, Sauteraud & Dartigues, 2001). The goal of cognitive-behavioral therapy is focused on the disruption of the ritualistic behavior and allows the individual to experience the anxiety without the ritual to develop coping skills and process the thoughts (Fisher & Wells, 2005).

The process of obsessive thoughts and ritualistic behaviors is interrupted causing the behavior to discontinue negative reinforcement of the anxiety breaking the ritual patterns. Treating the individuals with strategies to deal with anxiety teaches self-efficacy when reaching the desired goals. The therapist should specialize in cognitive therapy for training and knowledge to assist the individual in treatment (Barlow, 2007). The focus of this approach is different from Humanistic approach and other approaches by teaching to interrupt the ritualistic behavior

The Humanistic approach focuses on the existential assumptions that personal agency and free will are the idea of all individuals. The concepts to the theory are that individuals are basically good with innate desires to become better and make the world better. The humanistic approach emphasizes the self-worth of individuals and his or her values are of good nature. This approach is positive and optimistic theorizing the understanding that humans desire to be free of pain and despair. Maslow theorized personal growth as a primal human motive and personal growth are lifelong.

The Humanistic perspective was very popular after World War I (Dombeck, 2006). This approach is less effective in treating OCD than other approaches. Humanism embraces the assumption of an individual is a cognitive aware being. The main principle of humanism argues other schools of therapy apply the approach as the therapy and treatment of the mental illness instead of the individuals actively participating in maintaining his or her emotional state (Plante, 2011). The goals of humanistic therapy for OCD is focused on recreating a positive and appropriate environment.

The change in the individual’s environment assists him or her in development for evolving into mature healthy individuals. Psychological dysfunction with OCD is caused by a disruption in the development of individual’s maturity and social skills. The treatment enables the individuals to develop a natural environment and the abilities to live in a healthier environment and mental state. Humanistic therapy has the expectation of normalcy and that is the goal. This behavioral therapy encourages the replacement of bad behaviors with more appropriate ones.

The positive replacement of problems assists with less anxiety and fear. Research has not proven the humanistic approach to an effective treatment for relieving the symptoms of OCD (Dombeck, 2006). Unlike the Family system approach that shows best results in treating OCD. Family systems approach consists of assistance from the therapist with the family in assessing the individual’s disorder. The goal is to improve the communication of the unit. There are several techniques applied to accomplish this including for example changing the perceptions of the family.

Developing a rapport with the family assists the therapist in understanding the reasons the individuals became OCD with insight to the dynamics of the family unit. The therapist identifies the anxiety producing relationships between family members (Plante, 2011). Developing coping mechanisms to the symptoms of anxiety producing thoughts and ritualistic coping behavior is the main focus of treatment. The focus on reducing the symptoms of OCD of the individual includes comprehension and understanding of the anxiety and distress the individual experiences.

Identifying the source of the anxiety producing stressors assists with establishing new avenues to relate to the family unit, interrupting the individual's obsessive-compulsive behaviors (Zohar & Insel, 1987). The therapist attempts communication repair to re-establish healthy communication within the family and decrease any inaccurate assumptions by the family about the individual’s symptoms that increase the stressors that produce OCD symptoms. The approach focuses on disengaging dysfunctional family behaviors and establishes a better family relationship. The family unit contains the dysfunction that triggers OCD behaviors (Plante, 2011).

Family therapy is an effective treatment in addition to other therapies as part of a multimodal treatment focused on emotional disorders however; the severe symptoms of OCD require combined therapies (Stein, 2002). History shows psychological treatment focused on the individual with the family unit as the cause of OCD symptoms and behaviors. Family members were not included in the individual’s therapy. The family members were not considered relevant to the recovery of the individual. Later psychological discipline family system approach was established and applied in clinical applications (Plante, 2011).

Family systems therapy focuses on the inadequacies in the family unit. Family systems therapy is less efficient as a single therapy for the treatment of OCD therefore in combination with other therapies increases the successfulness of the treatment (Barlow, 2007). Psychodynamic therapy focuses on anxiety associated with unconscious emotional beliefs. Therapists apply basic psychodynamic techniques to anxiety disorders (Fisher & Wells, 2005). The individual and the therapist establish a relationship where the individual is encouraged to discuss openly the underlying reasons of the anxiety. Guided imagery is applied in the this approach.

The therapist assists the individual to identify and understand his or her issues as a reaction to current and past issues. The psychodynamic approach assists to uncover unconscious reactions therefore the therapist assists in interpreting the individual’s thoughts, feelings, and dreams. The therapist assists the individual in identifying the unconscious motives to resolve the negative emotions. Identifying the causes of anxiety is effective with treating anxiety disorders. Psychodynamic therapy develops treatment goals (McLean, Whittal, Thordarson, Taylor, Sochting, Koch, Anderson, 2001).

Severe cases of OCD are most effectively treated with a combined cognitive behavioral therapy and psychodynamic therapy in relieving the symptoms of OCD. Training psychodynamic clinicians to apply cognitive-behavioral techniques assist in a more successful treatment plan and successful treatment of individuals with OCD (Barlow, 2007). The major theoretical approaches of behavior assist psychologists with the understanding of mental disorders. Cognitive-behavioral approach focuses on measuring observable behavior by applying classical and operant conditioning to the individual’s behavior.

The humanistic approach focuses on the individual’s ability to develop the skills to become a more active with growth oriented goals (Plante, 2011). The family systems approach explains OCD behaviors originate from the consequences of family dysfunction. The psychodynamic approach focuses on the unconscious influence of the individual's lack of ability to develop healthy mental processes. Psychology assists in developing a healthy relationship in the unit relieving the individual of the symptoms of mental illness.

All of the approaches have advantages in treating specific disorders; some are proven more effective with specific challenges and some perspectives. The combination of various perspectives in clinical psychology allows the therapist to apply therapies for a more successful change in the individual’s behaviors. Research and clinical practice assist in uncovering the various human behaviors making development of these approaches change to accommodate these new discoveries of mental disorders and the treatments (Plante, 2011). The path to healthy homeostasis of the mind requires proper treatment to balance mental health.