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Treating OCD at Step 2

Jennie Hague, Georgina Miles

10 Jul 2024

Introduction

Prevalence estimates vary, but OCD is thought to affect between 1 and 4% of the population.  OCD is considered one of the most common mental health disorders in the UK and if left untreated is likely to remain a chronic problem (NICE, 2023).  Psychological therapies are an effective treatment for OCD with ERP consistently found to be helpful (Gava et al., 2007, Ost et al., 2016).   This 1 day workshop covers evidenced based low intensity CBT interventions that can be used by practitioners delivering low intensity CBT interventions.   The revised 2022 PWP national training curriculum includes guided self help interventions for OCD. This workshop provides an opportunity for new, and experienced low intensity CBT practitioners to update and refresh their knowledge about treating OCD, effectively at step 2.  


The event will be equivalent to 5.1/2hrs of CPD.

Content

The workshop will include:

• A refresher on the signs and symptoms of OCD
This portion of the workshop will include an overview of how OCD presents and what symptoms to look out for in assessment. We will define and outline what obsessions are, what compulsions are and how OCD presents clinically with reference to diagnostic criteria. We will consider current prevalence of OCD and how this relates to access rates for treatment in UK services.

• Use of routine outcome monitoring
Consideration how use of the Minimum Data set and anxiety disorder specific tools can enhance your assessment and treatment of OCD.

• Refresher of NICE treatment guidance
A reminder of what NICE recommends and what the evidence base states is suitable for treatment of OCD.

• Understanding the OCD cycle
With reference to relevant theory, we will provide an overview on how to understand the maintenance of OCD, and how this can be used to develop a shared understating with patients.

• Introduction to Exposure and Response Prevention for OCD
With reference to relevant theory, we will provide an overview on how to use low intensity ERP to effectively treat OCD.

• Trouble shooting common challenges
We will spend some time highlighting common challenges in working with OCD, and although we will be unlikely to solve all challenges, we hope to present a helpful framework for overcoming barriers in treatment for patients with OCD.

Learning Objectives

1. Demonstrate knowledge of, and competence in applying the principles and purpose of assessment undertaken with people with OCD
2. Demonstrate knowledge of, and competence in recognising patterns of symptoms consistent with diagnostic categories of OCD
3. Demonstrate knowledge and understanding of, and competence in using low intensity theory to understand the OCD cycle
4. Demonstrate in-depth understanding of, and competence in, low-intensity, evidence-based guided self-help psychological interventions for OCD
5. Demonstrate knowledge and understanding of, and competence in using the COM-B behaviour change model when working with OCD

Training Modalities

During the workshop the following methods will be use to facilitate learning such as didactic presentations, demonstrations, Q&A and reflective exercises. Skills practice will be encouraged as a post workshop task.

Key References

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed). Arlington, VA: American Psychiatric Association Publishing.

Gava, I., Barbui, C., Aguglia, E., et al. (2007) Psychological treatments versus treatment as usual for obsessive compulsive disorder (OCD). John Wiley & Sons, Ltd.

Laposa, J. M., Hawley, L. L., Grimm, K. J., Katz, D. E., & Rector, N. A. (2019). What Drives OCD Symptom Change During CBT Treatment? Temporal Relationships Among Obsessions and Compulsions. Behavior Therapy, 50(1), 87-100.

Lovell, K., Bower, P., Gellatly, J., Byford, S., Bee, P., McMillan, D., ... & Reynolds, S. (2017). Clinical effectiveness, cost-effectiveness and acceptability of low-intensity interventions in the management of obsessive–compulsive disorder: the Obsessive–Compulsive Treatment Efficacy randomised controlled Trial (OCTET). Health Technology Assessment, 21(37), 1-132.

Marrinan, T. in Papworth, M., & Marrinan, T. (eds). (2018). Low intensity cognitive behaviour therapy: a practitioner’s guide (2nd edition). London: SAGE.

National Institute for Health and Care Excellence (2005). Obsessive-compulsive disorder and body dysmorphic disorder: treatment (CG31). London: NICE.
https://www.nice.org.uk/guidance/cg31/resources/obsessivecompulsive-disorder-and-body-dysmorphic-disorder-treatment-pdf-975381519301

NHS England (2022). National Curriculum for Psychological Wellbeing Practitioner (PWP) Programmes. London: NHS England.

Öst, L. G., Riise, E. N., Wergeland, G. J., et al. (2016) Cognitive behavioral and pharmacological treatments of OCD in children: A systematic review and meta-analysis. Journal of Anxiety Disorders 43, 58-69

Purdon C. & Clark D. (1993). Obsessive intrusive thoughts in nonclinical subjects. Part 1 Content & relation with depressive, anxious & obsessional symptoms. Behaviour Research and Therapy, 31(8), 713-720.

Robinson, K. J., Rose, D., & Salkovskis, P. M. (2017). Seeking help for obsessive compulsive disorder (OCD): a qualitative study of the enablers and barriers conducted by a researcher with personal experience of OCD. Psychology and Psychotherapy: Theory, Research and Practice, 90(2), 193–211.

About the presenter

Jen worked as a PWP and later as a CBT therapist and supervisor in Sheffield NHS Talking Therapies for 12 years. Jen has been working as Programme Director for the Talking Therapies training courses since 2020 and was promoted to Senior Lecturer in 2022. Jen has clinical interests in Behavioural Activation, the assessment of PWP competency and the delivery of transdiagnostic protocols at Step 3.    

George has been the PWP Deputy Programme Director since 2022. She worked in the Sheffield Talking Therapies service as a PWP for 8 years, where she was part of the pathfinders project that worked on setting up the LTC service. She has previously worked within Substance Misuse for many years and also within Adult Mental Health in an assistant clinical psychologist role. Further to her work within the University she is also a member of the BPS course accreditation committee. 

Who should attend

Clinicians working as PWPs or who deliver low intensity CBT at any point in their careers are welcome to join this event.

Low Intensity clinical contact hours survey - BABCP Low Intensity Special Interest Group

Please click below if you are interested in contributing to the survey.

 

The BACP Low Intensity SIG are interested in the impact of clinical contact hours on Low Intensity/Wellbeing Practitioner wellbeing. This questionnaire contains six multi-choice questions and a free text box for you to share your experiences. The answers to these questions will help the BABCP SIG plan how to meet CPD topics and other developments within the SIG.  The SIG hope to produce a write up of the answers to this questionnaire to be shared with SIG members and to be used in training.

View Survey

This FREE conference is for Psychological Wellbeing Practitioners working in Talking Therapies for Anxiety and Depression services and is brought to you by Bespoke Mental Health in collaboration with the NHS National PWP Leads Network.

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