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Best Practices for Supporting Individuals with OCD

Writer's picture: Autumn YatesAutumn Yates

At our practice, we believe in staying up-to-date with evidence-based practices related to

the vast spectrum of our clients’ needs. One of many specialties that we focus on is the treatment of obsessive-compulsive disorder (OCD), a condition that can significantly impact daily life.


A close up of soapy hands under a running sink faucet
OCD is so much more than a preference for cleanliness.

Continue reading to learn more about this disorder, traditional treatments, and how we incorporate research-proven innovations to improve the quality of life of individuals with OCD. 


What is Obsessive Compulsive Disorder?

The severity of OCD is often downplayed thanks to general misconceptions about some of its symptoms. How many times have you heard a friend or colleague say something along the lines of “I’m a little OCD” or “That’s just my OCD”, simply because they like a neat house or an organized desk? In reality, OCD is a clinically-diagnosed psychological disorder that is significantly more serious than a mere preference for cleanliness.


A person diagnosed with OCD experiences severe and frequent obsessions. These obsessive thoughts feel both unwelcome and out of their control, consistently interfering with daily life. Obsessions can center around a variety of themes, including but not limited to:

  • Cleanliness/Germs

  • Perfectionism

  • Fear of harming themselves or others

Visit the International OCD Foundation for additional categories.


Individuals with OCD often cope with their obsessions by engaging in compulsions, which are repetitive behaviors that help them feel as though they’re reducing, or neutralizing the obsession. For example, someone with OCD who obsesses over germs might experience a compulsion to immediately take a scalding hot shower after someone shakes their hand. 


How has OCD traditionally been treated?

Until recently, standard Cognitive Behavioral Treatment (CBT) has been one of the most widely accepted ways to treat OCD. This approach focuses on the effects of the obsession. Let’s return to our handshake example. Standard CBT would aim to reduce the client’s negative reaction to the handshake and the resulting fear that they might get sick. In other words, clients are provided with coping strategies for when they experience the obsession, rather than exploring the root cause of the obsession in the first place. 


Practice owner and psychologist Amanda Van Emburgh speaks with another clinician in one of our therapy offices.
While ERP is one of several tools in our toolkit, we prefer to tailor our specific approach to each client's individual needs.

One specific type of Cognitive Behavioral Treatment that is used to treat OCD is called Exposure and Response Prevention (ERP). ERP practices confronting the obsessions and then actively refraining from the compulsions that usually follow. ERP is of course implemented under the guidance of a trained therapist, but even with professional support, it can still be extremely anxiety provoking.  When individuals are directed to expose themselves to the obsessions that so frequently plague them, they open themselves up to a great deal of vulnerability.


How does our team treat OCD?

Here at Family & Child Therapy, we recognize that the previously mentioned treatments have improved the quality of life of many people diagnosed with OCD, and we sometimes use ERP depending on the circumstances and client need. While ERP can still be found in our toolkit, we also want to acknowledge that every client is different and that the following concerns sometimes come into play:

  1. The anxiety caused by Exposure and Response Prevention can sometimes outweigh the benefits.

  2. Standard Cognitive Behavioral Treatment can be a “band-aid” approach - it may help to reduce the negative responses people have to their obsessive thoughts, but it doesn’t address the reason why the thoughts exist.

It’s reasons like these (in addition to the goal of adapting our offerings to suit individual client needs) that inspire us to continue learning about new treatment options.


That’s where Inference-Based Cognitive-Behavior Therapy (I-CBT) comes in. I-CBT is an evidence-based approach that treats the source of the obsessive thoughts so they are less likely to happen. I-CBT focuses on the reasoning process of people with OCD. According to the I-CBT approach, individuals with OCD mistake doubtful outcomes for probable outcomes, resulting in obsessions over things that are very unlikely to happen. In other words, faulty reasoning results in unrealistic inferences (hence the name of the therapy).


I-CBT works to introduce doubt into the faulty reasoning process. It helps OCD clients trust themselves to recognize and dismiss unrealistic outcomes before they become obsessions. Rather than the “putting out fires” approach of other methods, I-CBT provides individuals with the tools they need to prevent the fires from breaking out in the first place. That is why our team proudly incorporates I-CBT into our work with OCD clients.


I-CBT also helps when there isn’t a big “what if” or specific fear/doubt behind the obsession

A coffee cup, watch, pair of glasses, phone, notepad, pencil, paperweight and computer are lined up in a neat and orderly way on a desk or table.
I-CBT provides a helpful framework for a variety of OCD classifictions, including symmetry/order OCD.

and compulsion. For example, people who experience symmetry/order OCD often feel overwhelming discomfort or a strong “just not right” sensation if things are uneven, crooked, or mismatched. I-CBT works with them to understand the internal rules and assumptions fueling this sometimes outward physical discomfort and guides them toward separating the feeling from its importance. By tackling both the reasoning process and the discomfort itself, I-CBT offers a clear and practical way to manage OCD.


This is obviously a brief overview of a complex topic. There is so much more we can share about I-CBT and our approach to supporting individuals with OCD. If you or someone you know is searching for OCD-related treatment, please don’t hesitate to reach out. We are here and happy to help. 


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