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With a myriad of OCD treatments available, and online offers of quick fix cures for OCD (including news of a cat that was able to be registered with the regulatory body for hypnotherapists), we decided to take a look at what people can do when trying to find a therapist privately.
This article offers guidance on choosing the right therapist and advice on maintaining the therapeutic relationship when things go wrong, and can be applied to both private and NHS therapists.
The treatment of choice for both children and adults with OCD is Cognitive Behaviour Therapy (CBT), a form of talking therapy that includes Exposure and Response Prevention (ERP). This is recommended by the National Institute of Clinical Excellence (NICE) as the primary treatment method for the illness. Many people find they also benefit from the use of medication alongside the therapy (Selective Serotonin Re-uptake Inhibitors (SSRIs) are usually the medications of choice for treating OCD).
When choosing a therapist, especially if paying to go private, it is important to ask some relevant questions to allow you to gauge if your therapist is suitably qualified to be treating you.
The therapist should answer ‘yes’ to the following questions:
A good therapist will not mind you asking these questions and, in fact, any reluctance to answer these questions should in itself be enough to make you question if they are the right person for you.
Another factor when searching for therapists is to check their credentials and qualifications, but don’t be fooled by the fancy letters after a therapist’s name. There are many official sounding counselling and therapy bodies, but not all check the credentials of their members, so do your research and never be afraid to ask questions. We primarily recommend using therapists accredited with the British Association for Behavioural and Cognitive Psychotherapies (BABCP) which is the lead organisation in the UK for CBT therapists (not to be confused with the BACP or MBACP initials.).
Although there are more than 7,500 members of BABCP, only about 1,500 are accredited, so when searching for a CBT therapist it is important to check they are ‘accredited’ members of the BABCP.
Therapists need to meet strict criteria to become accredited by the BABCP. These include being a member of a specified core profession, following minimum training standards, and having a sustained commitment to the theory and practice of cognitive and behavioural therapies. This ensures that all accredited CBT Therapists have achieved a high level of competence in cognitive and behavioural methods, which has also been independently verified. However, it is worth noting that BABCP accreditation is not a qualification of excellence, so it is important to question each therapist you approach to establish if they are knowledgeable in OCD.
The BABCP is also responsible for the Accreditation of all ‘High Intensity' CBT courses which are being set up under the Government's £170 million Improving Access to Psychological Therapy programme (IAPT).
The BABCP website (www.babcp.com) allows you to search their database of accredited therapists; simply click the ‘find a therapist’ link, which will then take you to www.cbtregisteruk.com. From there, you simply select obsessive compulsive disorder in the ‘choose a condition’ field, and enter your postcode or town details. It is important to remember that even with BABCP accredited therapists you must still probe them, perhaps with the questions we suggested above, to check that they are a therapist with the required knowledge and expertise to treat you.
Other Claims of Special OCD treatment Methods
Occasionally you may also come across websites for individual therapists or private OCD clinics/centres that claim to provide a specialist treatment service that they may have developed differently from traditional Cognitive Behavioural Therapy. It is worth remembering that the treatment of choice for OCD is Cognitive Behavioural Therapy, the only psychological treatment shown to be effective, and therefore the only talking treatment recommended by the National Institute for Health and Clinical Excellence (NICE).
It is also important not to allow yourself to be persuaded by these websites, many of which look highly professional and glossy with lots of testimonials from recovered sufferers - they are selling a service and therefore will not be providing independent reviews!
You may also come across treatment methods written by people claiming to be ex-OCD and anxiety sufferers - don't assume that just because someone is an ex-sufferer, they are qualified to be a therapist to treat other people. So always, always check the professional background and clinical training of the therapist / treatment method author.
Many of these treatment method websites and clinics also claim to be NHS approved. In the past we have seen examples of this, where the author's own GP had recommended the treatment method to another client, and consequently was then being used by the author to support claims of ‘NHS approved’. Again, it is important to take these claims with a pinch of salt, and remember if these services were in fact fully NHS approved, then they would be recommended by the National Institute for Health and Clinical Excellence (NICE) in the treatment guidelines for OCD.
Disclosing Sensitive Information
For treatment to work it is important that you are open and honest with your therapist, no matter how strange or embarrassing your OCD may be. Most therapists will have heard such stories before anyway so it probably won’t shock them in the slightest.
Of course with some forms of OCD about harming or abusing people, especially children, it is natural that you may be afraid to tell someone. Yet while sadly not all health professionals have experienced these forms of OCD to be fully understanding, it should not put you off seeking treatment you deserve.
If this form of OCD applies to you, what we would recommend is perhaps talking about any other forms of OCD that you may be experiencing in the first instance, and loosely touch on the more sensitive topic without going into specifics. This can be done at least until such a time as you feel you can trust your therapist, and when you feel your therapist is showing some understanding of the problems you are experiencing. The chances are that when you start touching on the subject of harm the therapist may well understand what you are referring to and will actually help you express your fears, making you feel much more relaxed.
Should you have any problems expressing your OCD to your therapist, please do contact OCD-UK and we may be able to act as an independent intermediary for you.
So what happens if therapy is not working?
The therapeutic relationship plays a key factor in the success of a treatment - you and your therapist should be working and setting goals together and applying exercises as a team. However, even the most excellent of partnerships will sometimes slow down, and even hit the proverbial brick wall. In such situations it is important that you talk to your therapist, explain to them what you’re feeling and thinking about progress of the treatment.
Communication is vitally important for therapy to work.
In situations where the treatment does slow down, talking to your therapist should help. New goals can be set, and new exercises planned together (‘together’ being the operative word). Beware the therapist that simply turns round and accuses you of not working hard enough - it is important to be honest with yourself and sometimes we may need to push ourselves a little more, but invariably if a therapist mentions a lack of investment on your part, then this is the sign that a new partnership may be needed.
Although we always suggest talking problems through with your therapist first, if you really feel your therapy partnership has gone as far as it can, there is nothing wrong with searching for a new therapist. That is not a sign of failure; it may just be that a new approach is needed. Think of it like learning to drive; you don’t always pass your test first time and may need to try a different driving school. If you don’t pass first time, you try again, and if needs be, again and again until such time you’re driving down the road to an OCD free life.