Category: OCD and Related Disorders

Dallas OCD Therapists

Psychologists at Dallas CBT specialize in treatment for OCD in children and adults. Obsessive compulsive disorder (OCD) is considered among the most treatable conditions, meaning that people with OCD tend to get much better with therapy. Research indicates that Exposure and Response Prevention (ERP), a cognitive behavioral therapy, is the best treatment for OCD, over and above medication. ERP works by changing responses to intrusive thoughts and the behaviors that maintain anxiety over time.

We have all learned to do things that prevent scary or bad situations, such as locking our car doors or taking Vitamin C during cold season. In OCD, however, these behaviors can begin to take over one’s life. People with OCD often have disturbing and stressful thoughts, urges, or images (obsessions), such as fears about contracting a terrible disease or picturing oneself hurting another person. People with OCD can develop behaviors or routines to help reduce the distress caused by obsessions, such as frequent hand-washing, checking, or counting. These compulsions can help alleviate anxiety in the short-term but often become repetitive and take over one’s life, leading to more problems. OCD is not simply being a “neat-freak” or being concerned about orderliness; rather these obsessions and compulsions are time-consuming, distressing, and cause significant impairments in daily life.

Potential Signs of OCD

• Preoccupation with certain fears, such as contamination, harming self or others, acting out sexually, or offending God
• Stressful or scary thoughts, images, urges that pop up repeatedly in ones mind, or a frequent feeling that things are not “just right”
• Feeling compelled to do certain behaviors over and over again in order to feel less anxious or get rid of a certain thought
• Feeling like you cannot control the unwanted thoughts and behaviors
• Frequently being late because of compulsive behaviors

OCD Treatment in Dallas

Our state-of-the-art treatment involves Exposure and Response Prevention (ERP), an empirically-supported treatment for OCD. ERP involves gradual and systematic exposure to anxiety-provoking situations while simultaneously reducing and eliminating typical fear responses, such as escape or avoidance or compulsive behaviors in OCD (e.g., checking, washing, ordering). With young children, exposure-based CBT requires significant involvement from the parent(s).

The recommended dose for Exposure and Response Prevention is 17 to 20 sessions, but this can vary depending on needs. These sessions typically last 60 to 120 minutes and are held once or twice weekly.

Exposure therapy is a type of CBT that is highly effective for anxiety and obsessive-compulsive related disorders. In fact, it often performs just as well, if not better, than psychiatric medication for these issues. Exposure therapy involves a gradual and systematic approach to confronting fears and anxiety-provoking situations that you have been avoiding, with the aid and support of your therapist. Exposure provides the opportunity to learn that feared consequences are unlikely to come true and that with repeated exposure, you can desensitize and build tolerance to anxiety-provoking concerns. The overarching goal of exposure therapy is to reduce or eliminate avoidance of objectively safe situations, which leads to reduction in anxiety about these situations. This treatment causes short-term anxiety, as it involves facing the fears that you have been avoiding; however, it is the most effective way of overcoming OCD.

Dallas CBT provides specialized treatment for skin picking and other body-focused repetitive behaviors in children and adults. Excoriation, or skin picking disorder, involves strong and repeated urges to pick, squeeze, or scratch at skin, often at a spot where one perceives a skin defect. Picking usually occurs on the face, hands, or arms, and results in sores, cuts or lesions. Picking is often accompanied by anxious feelings, but the urges to pick might also occur without awareness. Individuals with skin picking disorder find it very difficult to stop picking, even when they notice skin damage, and may take steps to try to hide their cuts or sores.

Potential Signs of Excoriation Disorder

• Finding yourself picking at skin throughout the day such during class, watching TV, or falling asleep
• Preoccupation with skin that does not feel or look “right” (for example, skin that is rough, blemished, or uneven)
• Damage to the skin, including scabs, cuts, and sores
• Difficulty in stopping this behavior
• Having to find ways to cover up the skin damage cause by picking, such as with long-sleeves or other articles of clothing, makeup, or bandages

Treatment

Skip picking in Excoriation (also known as Dermatillomania) is a part of an ingrained behavioral pattern that is learned and has been reinforced over time. As such, it is possible for this behavior to be changed or “un-learned,” and replaced with healthier, more desirable behaviors. Though this is often very challenging for individuals to accomplish on their own, there are effective treatment options available to assist you with this process. Therapy at Dallas CBT is based on the Comprehensive Behavioral Model (ComB), which is a modern therapeutic approach for skin picking and other repetitive body-focused behaviors based on CBT principles.

The ComB model is a short-term treatment approach that involves identifying cues or triggers for skin picking, such as certain environments, activities, or emotional states, and the unique functions that picking serves for the individual. Therapy helps clients increase awareness and understanding of their behaviors and urges, identify important factors contributing to the behavior, assess the purpose of the behavior, and establish a set of personalized strategies to minimize and replace skin picking. Therapy will also teach individuals skills to modify problematic thoughts and feelings contributing to skin picking behaviors and establish non-harmful alternative behaviors that address the functions that picking serves. For children struggling with skin picking, an important component of therapy involves assisting parents with understanding the disorder and improving their ability to help their child manage this behavior and employ new strategies developed in therapy. Over the course of treatment, urges to pick will become increasingly weaker and easier to manage.

Dallas CBT psychologists specialize in treatment for Trichotillomania (TTM) and other body-focused repetitive behaviors (for example, skin-picking) in children and adults. It is not uncommon for individuals to develop certain repetitive behaviors, such as twirling their hair, clicking their tongue, or biting their nails or cheek. Most of the time, these behaviors are innocuous or nothing more than a habit. Sometimes, however, these repetitive behaviors become more extreme or severe. Trichotillomania, or hair pulling disorder, involves strong and repeated urges to pull or twist hair until it breaks or comes loose, and can often result in significant hair loss. There are many different reasons and ways that people pull hair, and these urges might occur with or without awareness. Likewise, hair might be pulled from anywhere on the body, such as scalp, eyebrows, eyelashes, underarm hair, arm and leg hair, pubic hair, or beard. Those struggling with trichotillomania may find it very difficult to stop, even when there are significant personal or social consequences to this behavior, such as noticeable bald spots. Trichotillomania can develop at any point in the lifespan, even in children ages 0 to 5.

Potential Signs of Trichotillomania

• Finding yourself pulling hair throughout the day such as during class, watching TV, or falling asleep
• Difficulty stopping hair pulling
• Preoccupation with the way a hair looks or feels
• Having to find ways to cover up hair loss, such as with makeup or wearing hats or wigs

Treatment

Hair pulling in Trichotillomania is a part of an established behavioral pattern that is learned or reinforced over time, and, as such, this behavior can also be changed or “un-learned.” Though this can be difficult for individuals to do on their own, there are good therapeutic options available. Treatment at Dallas CBT is based on the Comprehensive Behavioral Model (ComB), a state-of-the-art, effective therapy option for trichotillomania.

The ComB treatment approach involves identifying cues for hair pulling, such as settings, activities, or emotional states, and the functions that pulling serves for the individual. During treatment, therapists will help clients increase awareness of their behaviors and urges, identify important contributors to the behavior, evaluate the function of the behavior, and work on developing a set of alternative strategies uniquely tailored to each client. Therapy will teach individuals to modify problematic thoughts and feelings contributing to hair pulling behaviors and find healthy alternatives to address the functions that pulling serves. For children struggling with hair pulling, specific time will be spent in helping the parents understand the disorder and improving their ability to aid their child in management of this behavior. Over time with therapy, urges to pull will become weaker and easier to manage.