Breaking Free from OCD

A CBT Guide for Young People and Their Families

Jo Derisley, Isobel Heyman, Sarah Robinson, Cynthia Turner

• Publisher: Jessica Kingsley Publishers
• Year: 2008
• ISBN:
  9781846427992
• Topic: Psychology
• Subtopic: History & Theory in Psychology
• Index: Psychology

Part of the Reading Well scheme. 35 books selected by young people and health professionals to provide 13 to 18 year olds with high-quality support, information and advice about common mental health issues and related conditions.

Obsessive-compulsive disorder (OCD) is a potentially life-long debilitating disorder, which often emerges during teenage years and affects as many as 1 in every 50 people. Young people living with OCD experience recurrent obsessions or compulsions that are distressing and interfere with their social lives, relationships, educational functioning and careers.

Written by leading experts on OCD, this step-by-step guide is written for adolescents with OCD and their families, to be used in home treatment or as a self-help book. Using the principles of cognitive behavioural therapy (CBT), which is the proven method for helping those with OCD, it offers teenagers a structured plan of treatment which can be read alone, or with a parent, counsellor or mental health worker. The guide provides useful advice and worksheets throughout.

This self-help book for young people is an invaluable resource for adolescents who have suffered from, or know someone who has suffered from, OCD, their families, teachers, carers, and mental health professionals.

Part B

HOW TO RECOVER FROM YOUR OCD

In this part of the book we are going to help you learn techniques to recover from your OCD. All of the strategies used in this section are based on cognitive behaviour therapy (CBT). You have already been introduced to this type of talking treatment in Chapter 4, so you know that it is the effective treatment used by professionals who treat OCD.

Chapter 7 helps you understand your anxious feelings, as understanding anxiety is an important first step in recovering from your OCD. Chapter 8 then helps you understand your difficulties with OCD in more detail. To do this you will learn how to keep an OCD diary and how to make an OCD ladder. You can then use these ‘tools’ to start to tackle your OCD problems by learning a technique called exposure and response prevention, or E/RP for short. This is the main technique that you will master to help you overcome your OCD.

Occasionally, you may come up against some difficulties. There is a question-and-answer section, which will give you advice on how to overcome any problems that you may encounter when trying to make progress.

Sometimes OCD makes you really worried about upsetting thoughts, and you might find it difficult to make progress until you have worked on these worries. There is a chapter to help you understand how common these types of thoughts are when you have OCD, and advice on how best to challenge and test these thoughts. You will also learn how to test whether your

OCD thoughts are going to come true through the use of a technique called behavioural experiments.

Finally, once you have started to recover from OCD, you can learn how to maintain the gains that you have made, and what to do if OCD tries to reappear in your life!

Chapter 6

How to Use this Book to Change Your OCD

In the previous section you have learned what OCD is, how it can keep you caught in its trap, and about the treatment called CBT. The most powerful technique we use in CBT is a special sort of task called exposure and response prevention (E/RP). This is a psychological strategy that has been proven to work with OCD. Each E/RP task will help you understand and confront your OCD worries. Like all new skills it will involve practice and you will have to repeat tasks until you learn more about your OCD and your worries lessen. You may need to practise your E/RP exercises several times a day in order to make progress.

Obsessive compulsive disorder will make you feel frightened and want to avoid making any changes. It is therefore important to set time aside each week to fight your OCD. It may be helpful to use a timetable to schedule when you are going to practise your OCD tasks. You’ll find a timetable in Chapter 11, ‘Overcoming Difficulties’. It is recommended that the exercises in this workbook are completed in order, but you can repeat or return to sections if you want. After each chapter there is a chance to review what worked or did not work, and you can either continue working on that OCD task or set your next challenge.

Your OCD is very good at making you afraid to change anything! Because of this it is important to involve an adult helper to encourage you to fight your OCD symptoms. The ‘Advice for parents or carers’ sections in each chapter will assist your adult helper. The helper doesn’t have to be a parent. They might be a guardian, carer or counsellor, or another important adult who knows you well and can support you in making changes even when you feel unsure or frightened. Remember that you can read those sections too. It may help to talk this section through with the person helping you so that you can plan each task until you become more confident in your ability to tackle your OCD successfully on your own. There are worksheets throughout the book to help you with your OCD challenges. These can all be photocopied.

CHLOE

Chloe was very worried about germs, and wanted to wash all of her cutlery and plates before she used them. She was worried that if she didn’t do this she would get very ill. She found it very difficult to start the first task, aimed at helping her on the road to recovery. She avoided doing the tasks by telling herself that ‘it wouldn’t work anyway’, ‘it was too risky to attempt’, and that ‘it was OK to continue doing her OCD rituals’. She always planned to start the tasks tomorrow, but tomorrow never came. Chloe discussed this avoidance with her mum and they decided to use the timetable to schedule in tasks to complete throughout the week. After each task they also scheduled a time to sit down and review the tasks, and a time to schedule in something that Chloe could look forward to doing to encourage her to want to continue facing her worries. This helped Chloe start to make changes.

MEASURING YOUR OCD

One thing that you may find helpful and interesting to do before you start to fight back against OCD is to complete a brief questionnaire (see the Appendix section). This questionnaire will provide you with a rough idea of how much the obsessions and compulsions are interfering in your life. It is helpful to complete this questionnaire once now (before you start to overcome OCD) and again when you finish working through all of the chapters in Part B of this book. This will allow you to compare the scores that you obtain, and to see whether your OCD symptoms have changed as a result of the work that you have done.

You need to score the questionnaire. You will be able to get a separate score for how much the compulsions and the obsessions are interfering in your life.

To score the compulsions part of the questionnaire, you will find six questions that ask:

• how much time you spend doing compulsions
• how much the compulsions get in the way of you doing things
• how upset you would feel if you were prevented from doing the compulsions
• how much you try to fight the compulsions
• how strong the feeling is that you have to carry out the compulsions, and
• how much you have been avoiding things, places or people because of the compulsions.

To get a score that will indicate how much the compulsions are interfering in your life, simply add up the numbers that you have circled for each of these questions. Put your score in the space provided below.

To score the obsession part of the questionnaire, you will find six questions that ask:

• how much time you spend thinking about the obsessions
• how much the thoughts get in the way of you doing things
• how much the thoughts bother you or upset you
• how hard you try to stop the thoughts or ignore them
• how much control you have over the thoughts, and
• how much you have been avoiding things, places or people because of the thoughts.

To get a score that will indicate how much the obsessions are interfering in your life, simply add up the numbers that you have circled for each of these questions. Put your score in the space provided below.

Compulsions interference score: ______

Obsessions interference score: ______

TOTAL interference score: ___...

Table of contents

• Cover Page
• Of Related Interest
• Title Page
• Copyright
• Contents
• Part A: Understanding Your OCD
• Part B: How to Recover from Your OCD
• Part C: OCD and the Bigger Picture
• Appendix: Questionnaire
• Index