On October 28, 2015, Dr. Elizabeth Wassenaar, Lindner Center of HOPE Psychiatrist and Williams House Medical Director, joined Lon Woodbury on the Woodbury Report radio show. Their discussion focused on outlining the benefits of a residential assessment for mental health concerns in adolescents.
To download and listen to the program, click here.
Obsessive Compulsive Disorder (OCD) was once thought to be an untreatable condition. However, in the past 30 years psychiatric and psychological treatment advances now allow individuals with OCD to manage and overcome their symptoms and live fulfilling and meaningful lives. Untreated OCD is a potentially disabling condition that strikes children and adults. Estimates of up to three percent of the population will battle OCD at some point in their lives and it affects men and women in equal numbers. It delivers a staggering toll for the individual and society, as individuals with OCD to have much higher than expected rates of under-employment and unemployment. With treatment , a person suffering OCD can now expect to free themselves from OCD’s grip. Dr. Charles Brady, from Lindner Center of HOPE’s OCD and Anxiety treatment program will discuss the nature of OCD including how it is diagnosed and how current evidence based treatments are able to help individuals reclaim their lives.
Guest Bio:
Dr. Charles F. Brady directs the Lindner Center of HOPE’s Obsessive Compulsive Disorder and Anxiety treatment program. He leads the research and development of the Center’s psychiatric rehabilitation programming. Dr. Brady is a clinical psychologist with over 20 years experience on the staff and faculty of the University of Cincinnati’s Department of Psychiatry. In addition to providing clinical service at UC, he trained and supervised interns, doctoral students, post-doctoral fellows, psychiatric residents, psychiatric fellows, and psychiatrists. Dr. Brady earned his Doctorate of Clinical-Community Psychology from University of South Carolina and completed his post-doctoral fellowship in the Department of Psychiatry at the University of Cincinnati College of Medicine. He has completed training in the treatment of OCD and OCD spectrum disorders through the Behavior Therapy Institute. Dr. Brady is Board Certified in Clinical Psychology by the American Board of Professional Psychology.
Mason, OH, November 24, 2014 – Lindner Center of HOPE staff psychologist, Charles Brady, PhD, ABPP, is a finalist for the 18th annual Business Courier Health Care Heroes awards in the provider category. Dr. Brady is one of 19 total finalists and one of five in the provider category.
Winners will be announced at a dinner on Thursday, February 12, 2015.
Dr. Brady directs the Center’s Obsessive Compulsive Disorder and Anxiety treatment program and oversees the Supported Employment program. He leads
the research and development of the Center’s psychiatric rehabilitation programming. He also currently serves as the president of the board of managers of Lindner Center Professional Associates.
Dr. Brady is a clinical psychologist with more than 20 years of experience on the staff and faculty of the University of Cincinnati’s Department of Psychiatry. In addition to providing clinical service to thousands of patients at UC, he trained and supervised numerous psychology interns, doctoral students, post-doctoral fellows, psychiatric residents, psychiatric fellows, and psychiatrists.
Approximately 2 to3 million adults and ½ million children in the United States have OCD, but more than any other psychological conditions, individuals with OCD encounter obstacles that are estimated to cause an average of 14-17 years between the onset of symptoms and accurate diagnosis and effective treatment. Common obstacles include a shortage of properly trained health professionals and inaccurate or insufficient public awareness. On many levels, Dr. Brady works to address these challenges.
Dr. Brady’s positive impact as a provider is not limited to merely the population of patients he works with directly, instead his focus has always been on devising the best and most efficient ways to reach as many individuals as possible. Having established a well-respected reputation as one of the nation’s Obsessive Compulsive Disorder experts, Dr. Brady’s unique understanding of OCD and his experience in achieving positive, measurable progress is highly sought after by patients and families across the country.
It was obvious to Dr. Brady early on that, individuals suffering with OCD were underserved. To that end, Dr. Brady made it his personal mission to address the need of those struggling with OCD, seeking specialized training on his own and rising to among the most respected OCD specialists in the country.
With a keen understanding of the rarity of his training and expertise, Dr. Brady has devoted his career to sharing his knowledge and talents with those who can take it forward and multiply the impact on the suffering caused by OCD.
Heath Care Heroes is the Business Courier’s recognition of those who have made an impact on health care in our community through their concern for patients, their research and inventions, their management skills, their innovative programs for employees and their services.
Lindner Center of HOPE provides excellent, patient-centered, scientifically-advanced care for individuals suffering with mental illness. A state-of-the-science, mental health center and charter member of the National Network of Depression Centers, the Center provides psychiatric hospitalization and partial hospitalization for individuals age 12-years-old and older, outpatient services for all ages, diagnostic and short-term residential services for adults and adolescents, intensive outpatient program for substance abuse and co-occurring disorders for adults and research. The Center is enhanced by its partnership with UC Health as its clinicians are ranked among the best providers locally, nationally and internationally. Together Lindner Center of HOPE and UC Health offer a true system of mental health care in the Greater Cincinnati area and across the country. The Center is also affiliated with the University of Cincinnati (UC) College of Medicine.
Patients with obsessive-compulsive disorder (OCD) frequently experience problems with disturbing, intrusive thoughts, as well as overwhelming impulses to perform ritualistic behaviors that reduce the anxiety associated with such thoughts. Traditional psychotherapy has not been found to be helpful for most individuals with OCD. However, one modern form of treatment is particularly successful in overcoming symptoms of the disorder.
The nature of cognitive-behavioral therapy
OCD patients typically become distressed about negative thoughts or obsessions, because they see them as warnings of potentially dangerous events. Cognitive –behavioral therapy (CBT) helps patients identify such unrealistic thoughts and reinterpret them, thereby reducing anxiety. Fewer anxious thoughts lead to decreased compulsive behavior.
How does CBT work? Treatment focuses on helping patients examine the relationship between their feelings, thoughts, and behaviors. Using a collaborative and structured approach, therapists guide patients to explore and expose themselves to their fears and anxieties in a controlled and safe environment. The beliefs surrounding those fears are also identified, challenged, and ultimately changed.
Patients learn to recognize their worries as being obsessions and to see their rituals as compulsions. Treatment includes a variety of structured techniques and strategies.
Homework
Working on assignments between therapy sessions is an important part of the treatment process. Patients are usually asked to keep a journal or “thought record” of their obsessions, in which they write down each one when it occurs, as well as their interpretation of its meaning. The therapist reviews the journal with the patient and helps challenge any unrealistic beliefs or “magical thinking” that surrounds the obsessive thoughts.
Behavioral Experiments
Once a patient understands the relationships between thoughts and behaviors, therapy may progress to the use of behavioral “experiments,” in which the patient practices what has been learned. An individual who believes that touching a doorknob three times will prevent her house from burning down may be asked by her therapist to touch it only once, then leave the house. She will then see that nothing catastrophic happens.
One effective type of behavioral experiment is the use of exposure and ritual prevention. This technique involves a patient’s prolonged exposure to a distressing situation or object, along with strict prevention of any associated ritualistic behavior.
First the patient is exposed to a situation or cue that stimulates obsessive thoughts. For example, a patient with a germ obsession may find that touching a faucet in a public restroom triggers thoughts of contracting a fatal disease. These thoughts, in turn, lead to compulsive hand washing. During exposure, the patient may actually touch the restroom faucet, while imagining the possible horrible consequences associated with this action.
Following exposure to the triggering obsessive thought, the patient is asked to abstain from performing the behavior believed to prevent the feared consequence; e.g., ritual hand washing. After several exposures, followed by no performance of the compulsive act, the patient realizes that the feared consequence does not occur if the compulsive act is not performed. More importantly, the patient realizes that distress and anxiety can lesson even without performance of the ritualized behaviors.
Finally, the patient and therapist process the patient’s experience during or after the experiment and discuss how the experience affects the patient’s beliefs and fears.
CBT is generally successful as a short-term therapy, and it has achieved very positive results with a variety of patients.
Constant hand washing, repetitive touching of doorways, checking ten times to make sure the stove is turned off: these are all examples of behaviors we frequently associate with obsessive compulsive disorder, or OCD.
The nature of obsessive compulsive disorder
OCD is a type of anxiety disorder, characterized by unwanted, uncontrollable thoughts as well as repetitive or ritualized behaviors. While the thoughts and actions are irrational and unproductive, the affected individual is unable to resist the urge to express them.
An obsession is a frequent and uncontrollable impulse, thought, or mental image that an individual experiences. They are often quite disturbing or unpleasant, as well as distracting.
A compulsion is a behavior or ritual that an individual repeatedly completes as a way of trying to make an obsessive thought go away. Individuals with obsessive thoughts about being unclean may wash their hands until they are raw. However, compulsive behavior not only does not reduce an obsession; these frustrating and time-consuming acts usually increase anxiety.
Treatment of obsessive compulsive disorder
OCD is a mental disorder that responds successfully to treatment. The two most effective types of OCD treatment are cognitive-behavioral therapy and medication, often used in combination.
Cognitive-behavioral therapy, or CBT, is a type of psychotherapy that involves retraining one’s thought patterns so that compulsive behaviors no longer feel necessary.
Two CBT components are most effective in treatment of obsessive compulsive disorder:
Medication has also been found to be effective in obsessive compulsive disorder treatment for many individuals. Some psychiatric or psychotropic medications help control obsessions and compulsions. These include antidepressants that increase serotonin levels in the brain, which may be low in individuals with OCD. Medication, if indicated, is normally used in conjunction with psychotherapy.
Professional treatment for OCD is highly effective, with research findings of long-term recovery rates of up to 75% or more. With proper intervention, individuals struggling with the anxiety and frustration of obsessive compulsive disorder can resume productive lives.