How to Attend Therapy for Compulsions

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1Choosing the Right Kind of Therapy

2Preparing For Your First Therapy Session

3Undergoing Therapy for Compulsions

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Compulsions, which are part of Obsessive Compulsive Disorder (OCD), are behaviors, thoughts, or rituals that someone repeats over and over. This is done in an effort to neutralize or eliminate obsessions or threatening thoughts. Compulsions can interfere with every aspect of a person’s life. Though OCD can be treated with medication, therapy is usually the first type of treatment used to manage obsessions and compulsions. If you experience compulsive behavior, you can learn how to start attending therapy to get the treatment you need.

Steps

Part 1

Part 1 of 3:

Choosing the Right Kind of Therapy

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   Find an OCD specialist in your area. To start attending therapy for your compulsions, you should find a mental health professional in your area who has experience treating compulsions. Look for therapists, psychologists, or counselors who have licenses and degrees from accredited programs and institutions.

   • If you are being treated by a psychiatrist through medication, you may want to ask them for a referral to a therapist who can help you.
   • Your general practitioner may be able to refer you to a specialist. You can also search for counseling centers that treat OCD in your area.
   • There are online databases that can help you find compulsion specialists in your area. Browse the database provided through [the International OCD Foundation] or [Psychology Today] for a list of OCD specialists in your area in the United States. Other psychology websites may also list specialists in your area.
   • You may want to interview therapists before choosing one. You can ask the therapist how they approach the treatment of compulsions, what their background with compulsions and OCD is, how much of the practice treats OCD or anxiety disorders, and what their feelings about medication treatment are.
   • If the idea of interviewing therapists is too daunting for you, then consider asking a friend to help you, or use other ways to learn more about the therapist, such as by reading their online profile.
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   Choose the right therapy for you. There are two main types of therapy for obsessive compulsive disorder. Depending on how your compulsions manifest, one type of therapy may be better for you than the other.

   • The most common type of therapy for OCD is cognitive behavior therapy. In CBT, a therapist will work with you to address and change negative thought patterns that lead to your compulsive behavior.
   • Another type of therapy is exposure and response prevention (ERP). This is a type of CBT that is geared specifically towards obsessions and compulsions. For compulsions, you would focus on the response prevention, which aims to help you learn how to not give in to your compulsions when you feel triggered or anxious about something. Not all therapists will be trained or familiar with ERP therapy.
   • Talk therapy is another type of psychotherapy. CBT is often used as part of talk therapy, along with other strategies that help you figure out the root of your compulsions. Talk therapy aims to help you deal with underlying issues.
   • If you are not sure about what your compulsions are, then consider what behaviors affect your daily life. Think about what you used to be able to do that you can no longer do. Why do you think you are no longer able to do these things? For example, do you worry so much about the house not being locked up that you cannot leave your home? Or, do you have to wash your hands so many time per day that it is affecting your work life? If so, then therapy may be helpful to you.
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   Determine the kind of program that is right for you. There are different types of therapy sessions you can choose to attend. The type of therapy you choose may depend on a lot of factors. You may be limited by what’s in your area, what your insurance will pay for, or what you are comfortable with.

   • The most common type of therapy is outpatient sessions, where you see your therapist once or twice a week. The sessions usually last for 45 to 50 minutes.
   • If you need more intensive therapy, you may attend sessions more times a week. You may attend group or solo sessions multiple days a week, or you may attend both group and solo sessions once a day for multiple days. This type of therapy is often conducted through clinics.
   • Day programs are another type of intensive treatment program. You go to a mental health clinic for eight hours multiple days a week to attend group and individual therapy sessions.
   • Hospitalization or long-term care facilities may be chosen if your compulsions are severe and you need intensive, around-the-clock treatment and therapy. During an inpatient therapy stay, you will go through individual, group, and family therapy sessions, along with medication therapy.
   • Some clinics offer online and telephone distance therapy. This type of therapy is beneficial if there is no good clinic or therapist in your area. Many qualified clinics offer online or telephone therapy, but you should look for quality in-person therapy before this option. If you choose distance therapy, make sure to fully research the clinic or center before undergoing therapy to make sure they are qualified and legitimate.
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Part 2

Part 2 of 3:

Preparing For Your First Therapy Session

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   Examine your insurance plan. Many insurance companies cover medical and therapy costs associated with mental illnesses. However, some do not. Most therapists and OCD clinics or treatment centers accept insurance. As you prepare to go to therapy, you should find out if your insurance covers therapy, what it covers, and any other costs you may have to pay.

   • Many insurance companies have in-network therapists they will cover. Some centers or therapists will offer insurance options for out-of-network clients.
   • Therapy sessions usually range from $50 to $150. If you have to pay out of pocket, you should discuss payment options with your family and therapist.
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   Acknowledge your compulsions. One of the first steps in letting go of your compulsions is to acknowledge that you have compulsions, that they are a problem, and that you want to get rid of them. In therapy, your therapist will work with you to identify your compulsions, but you can start thinking about them before your first session.

   • Some of your compulsions will be really obvious. Be ready to talk about those with your therapist. You may want to think about what triggers your compulsions, too. A trigger is something that causes your condition to get worse. Any information you can share with your therapist will be helpful.
   • If you are thinking about therapy, you probably know you have OCD or a problem with compulsions. You need to be honest with yourself about your problem and need to seek help. Think about any rituals or actions you must do or you will have extreme anxiety. For example, if you have to count things over and over to keep from getting anxious or upset, you may have a counting compulsion.
   • Other types of compulsions may involve obsessively washing your hands, checking locks over and over, or having to have all the food in your cupboard organized so that the labels face the same direction.
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   Be ready for a change. You may have been treating your compulsions with medication for a while. You may think that you are managing just fine. But if you are thinking about going to therapy, you must feel there is something more that can be done for your compulsive behavior. Keep in mind that you do not have to work through your condition alone and that there are experts who can help you. Before you go to therapy, make up your mind to work on changing your behavior and making yourself the best you can be.

   • Overcoming your compulsions and letting go of rituals may seem challenging, but there are mental health professionals who can help you. Therapy has helped many people with OCD and it may help you, too.
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   Manage your expectations. Going to one therapy session with not eliminate your compulsive behavior or erase your anxieties. You will not suddenly be cured of your OCD or learn how to manage it. Therapy is an ongoing treatment. It may take a while for you to see results. Don’t get discouraged or give up. The only way you will not get better is if you stop trying to treat and manage your disorder.

   • The amount of time it takes to start seeing results varies from person to person. Never compare yourself to others. Your journey, compulsions, and anxieties are unique to you.
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Part 3

Part 3 of 3:

Undergoing Therapy for Compulsions

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   Undergo response therapy. When you attend therapy for your compulsions, you may undergo response or ritual therapy. During response therapy, you will work with your therapist on reducing the urge to give into your compulsion when triggered. The goal of this therapy is to help you be able to resist your compulsion.

   • In this therapy, you will work on dispelling the belief that engaging in the compulsion will make a bad outcome not happen. You also work on reducing anxiety connected with not doing the compulsion.
   • During this therapy, you will identify your compulsions or rituals. You may be encouraged to keep a diary with your rituals. Your therapist and you will use the diary to identify compulsions and areas where you are struggling to overcome compulsions.
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   Attend cognitive therapy. Cognitive behavior therapy is a common therapy treatment for compulsions. During this therapy, you will work on changing negative thoughts that lead to compulsions. You will work with your therapist on refocusing thought patterns into healthier thoughts so you do not feel the compulsions.

   • For example, your therapist will help you identify your compulsions and helps you realize the difference between your perceived anxieties that lead to the compulsions and reality. Your therapist may help you realize that you will not get sick even if you do not wash your hands ten times a day.
   • In CBT, you will work on building positive thinking patterns so that you do not feel the need for your compulsions.
   • Your therapist may say, "Not counting all the peas on your plate over and over won't make you sick. Try only counting your peas at the beginning of dinner, or try eating one meal a week where you don't count your peas and see if you get sick."
   • Keep in mind that this process will take time and it is important to go at a slow, steady pace. Try to be patient and look for small indications of progress along the way.
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   Attend talk therapy. You may find that including talk psychotherapy into your therapy treatment plan is helpful. In talk therapy, you and your therapist talk about things going on in your life that may be causing or feeding the OCD. You discuss underlying conditions or issues that may be related to the compulsions, and talk through them.

   • For example, you may feel like a failure because of your compulsions, or because of a completely unrelated reason. During talk psychotherapy, you can talk through your feelings of failure so that you can come to a healthier mental state.
   • Your therapist may say, "Tell me about your childhood" or "What makes you anxious about not counting/washing your hands?" Your therapist may also ask, "Why do you feel like a failure?"
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   Go to group therapy. Group therapy may be a helpful type of therapy for you. Group therapy puts you into a safe space with other people who have OCD and compulsive behavior. During group therapy, a trained therapist facilitates the discussion between the people in the group. In this setting, you have the opportunity to share your experience with people facing similar problems and ask them questions about how they deal with things.

   • Group therapy sessions may have a specific focus.
   • You can learn how other people approach dealing with their compulsions, how they interact in social situations, or how they maintain relationships.
   • Group therapy may also focus on skills, such as mindfulness, relaxation, or deep breathing techniques to help you learn how to manage your anxiety.
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   Consider family therapy. If your compulsions are affecting your entire family, you may want to suggest everyone go to family therapy after you have been doing individual therapy for a while. In family therapy, your family can learn how to deal with your compulsions, how to help you, and how to take care of themselves. Family therapy helps with conflict resolution and promotes understanding of the compulsions.

   • Family therapy also offers a safe space for everyone in your family to discuss their concerns, fears, or problems in a constructive way.
   • For example, in family therapy you may say, "I feel that you don't full understand my compulsions" or "I need more support from you." Your family may say, "I don't understand why they have compulsions" or "I want to help, but I don't know how."
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   Start medically-assisted OCD therapy. If you are not already taking medication for your OCD, you may want to consider medically assisted OCD therapy. Combined with psychotherapy, medication is a common and effective treatment for OCD symptoms. Talk to your doctor or psychiatrist about medication therapy.

   • Medication can help some people with their OCD symptoms as a short-term solution or as a way to control acute symptoms, so it may help you in these situations as well.
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   Find a support group. Support groups aren’t always lead by mental health professionals. Instead of a therapy-focused session, support groups offer support and understanding from those in similar situations. Support groups are helpful if you are struggling and need encouragement or hope.

   • Support groups often meet independently of any mental health clinic or treatment center.
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