Wednesday, April 1, 2015

What are good resources on OCD?

Psychologist Katherine K. Dahlsgaard, Ph.D., from CHOP offers her recommendations on the best resources for families on obsessive-compulsive disorder.

What are good resources on OCD?

iStockphoto

A significant part of my work as a cognitive-behavioral therapist specializing in anxiety and related disorders is providing families with recommendations for good resources. “Good resources,” in these cases, are usually books and websites that offer general, up-to-date information on the disorder for which I am treating the child, as well as sound suggestions for at-home interventions (i.e., parent manuals).

Of course, I provide such psychoeducation in session, but I like parents to be able to hear the information more than once, from more than one source, and for it to be accessible to them outside of the therapy hour.

What I do not want is for families to garner information or recommendations for treatments from “unsafe” sources – that is, sources that provide information that is not scientifically supported or has been directly contradicted by science.  In fact, I explicitly warn families about this, because there is so much misinformation on the web.

During initial sessions, when giving my families handouts printed with what I think are the best and safest sources of information on their child’s disorder and treatment for that disorder, I typically say: “Please DO NOT put the name of your child’s diagnosis into Google search and hit ‘return.’ You will receive millions of hits, many of them from untrustworthy sources having something to sell, and you will feel even more overwhelmed than you already do.  Instead, start with these I am recommending – you can always read more later.”

In the following weeks, I will share my current recommendations for good resources for a variety of disorders that I commonly treat. I’ll start with obsessive-compulsive disorder.

OCD is characterized by two main symptoms: 1) obsessions, which are repetitive thoughts, images, or doubts that CAUSE DISTRESS (e.g., fear, disgust), and 2) compulsions, which are behaviors performed to neutralize the distress of obsessions. I’m stressing the distress aspect of obsessions here for a reason: I often hear from parents (and even some treatment providers) that a child has OCD because he is “obsessed with trains.”  Being obsessed with trains is like being obsessed with smoking: people do it because they LIKE to do it. NO ONE likes having OCD.

In terms of treatment for OCD, The American Academy of Child and Adolescent Psychiatry (AACAP) deemed cognitive-behavioral therapy (CBT) the evidence-based, recommended treatment for mild to moderate cases of pediatric OCD in their 1998 and 2012 practice parameters. The treatment guideline for severe cases of OCD is the combination of CBT and an SSRI such as Prozac or Zoloft.

This is because many well-controlled, randomized studies with children and adults have consistently shown the success of a type of CBT, specifically exposure and response prevention (ERP). Very briefly, ERP involves helping OCD sufferers gradually and repeatedly expose themselves to the distressing thoughts or situations without engaging in avoidance or other neutralizing compulsions. Over time, distress diminishes, along with the urge to perform the compulsions. Published reviews of OCD treatment studies report that ERP benefited 60 percent to 90 percent of those with OCD, typically with a 50 percent to 80 percent reduction in symptoms.

Recommended resources:

Website:

The best one-stop shopping website for general information on OCD is run by the International OCD Foundation at www.ocfoundation.org. The website is run by a non-for-profit organization and features good general information, a special section on OCD in children and teens, reviews of current treatment recommendations, and even a section on good questions to ask when interviewing a potential therapist for ERP. There’s a newsletter!

Conferences/Workshops/Support Groups:

The IOCDF also runs a pretty awesome annual conference that attracts a mixture of researchers, treatment providers, and those with OCD – it will happen in Atlanta this year July 19-21 and will feature a weekend workshop for kids with OCD (and their siblings!) entitled, delightfully, “Kicking OCD’s Butt.”

Books for children/books for parents:

My go-to recommendation for an intervention and tips guide for OCD is Dawn Huebner’s stupendous What to Do When Your Brain Gets Stuck: A Kid’s Guide for Overcoming OCD. A brief workbook for the intended audience of 6-12 year olds, I recommend this to just about every family I see – yes, even to the parents – because it is well-written, good with translating ERP interventions to the everyday, and is SHORT (meaning: kids and parents will actually read the whole thing).  It’s also lighthearted and funny.

Nerd Corner:

Occasionally, the more skeptical and/or science-minded of my patients asks for published, scientific studies.  (Note: I love this).  For OCD, I send them directly to AACAP’s published treatment guidelines. Bad news: It’s 16 pages. Good news: Every one of those pages is a goldmine.


Read more from the Healthy Kids blog »

Katherine K. Dahlsgaard, Ph.D. Lead Psychologist of The Anxiety Behaviors Clinic at Children's Hospital of Philadelphia
About this blog
The Healthy Kids blog is your window into the latest news, research and advice around children's health. Learn more about our growing list of contributors here.

If you have questions about your child's health, ask them here.

Anna Nguyen Healthy Kids blog Editor
Sarah Levin Allen, Ph.D., CBIS Assistant Professor of Psychology at Philadelphia College of Osteopathic Medicine
Stephen Aronoff, M.D., M.B.A. Chair of the Department of Pediatrics at Temple University Hospital
Peter Bidey, D.O. Medical Director of Family Medicine at Philadelphia College of Osteopathic Medicine
Christopher C. Chang, MD, PhD, MBA, FAAAAI, FACAAI Associate Professor of Medicine in division of Rheumatology, Allergy and Clinical Immunology at UC Davis
Katherine K. Dahlsgaard, Ph.D. Lead Psychologist of The Anxiety Behaviors Clinic at Children's Hospital of Philadelphia
Gary A. Emmett, M.D., F.A.A.P Director of Hospital Pediatrics at TJU Hospital & Pediatrics Professor at Thomas Jefferson Univ.
Magee DeFelice, M.D. Division Chief of Allergy and Immunology at Nemours/Alfred I. duPont Hospital for Children
Hazel Guinto-Ocampo, M.D. Chief of Pediatric Emergency Services at Nemours duPont Pediatrics/Bryn Mawr Hospital
Rima Himelstein, M.D. Adolescent Medicine Specialist at Crozer-Keystone Health System
Jessica Kendorski, PhD, NCSP, BCBA-D Associate Professor in School Psychology/Applied Behavior Analysis at Philadelphia College of Osteopathic Medicine
Anita Kulick President & CEO, Educating Communities for Parenting
Janet Rosenzweig, MS, PhD, MPA VP for Programs & Research for Prevent Child Abuse America
Beth Wallace Smith, R.D. Registered Dietitian at Children's Hospital of Philadelphia
Emiliano Tatar, M.D. Pediatrician at Einstein Healthcare Network Roxborough Plaza
Jeanette Trella, Pharm.D Managing Director at The Poison Control Center at CHOP
W. Douglas Tynan, Ph.D., ABPP Director of Integrated Health Care for American Psychological Association
Flaura Koplin Winston, M.D., Ph.D. Scientific Director of the Children’s Hospital of Philadelphia’s Center for Injury Research and Prevention
Latest Videos
Also on Philly.com:
Stay Connected