If you live in the UK, you can be assessed and, once you’ve been diagnosed, treated for your OCD through the NHS. Some people choose instead to have treatment privately. This can be for a number of reasons, like not wanting to wait for NHS treatment or in order to have more choice over who they work with and how many sessions they can attend.
The NHS have said they have done all they can – should I look privately?
The NHS works on a stepped care system. This means that if the treatment you have received wasn’t specialized or intensive enough for you, or if there is no treatment for OCD available through the service you have been referred to, you should be “stepped up” to a more specialised service until you receive appropriate treatment.
It can sometimes be a fight to get the right treatment. You can get in touch with our helpline for information about how to ask for it and make sure you are offered it, and if you are being unfairly refused the treatment you have a right to we also have an advocacy service that can help. Sometimes, though, it’s just about knowing how to ask for it.
You can choose to look at private therapists if you’d rather not go through the whole process, but it can become very expensive, and if you do choose to get treatment through the NHS we will be happy to work with you every step of the way.
What type of therapist should I get in touch with?
The only type of therapy that is recommended for OCD is Cognitive Behavioural Therapy with Exposure Response Prevention (CBT with ERP), which is a specialized type of CBT that is used to treat OCD and related disorders. This is based on research on a variety of therapies, which has only shown this type of therapy to be successful in reducing the symptoms of OCD.
First you need to make sure that your therapist’s qualifications and experience are of a high enough level. One way to be sure of this is to find a therapist who has received an accredited status from the BABCP, as they set the professional standards for cognitive behavioural therapy. An accredited therapist with the BABCP will have achieved minimum training requirements, attends regular supervision, and maintains their Continuing Professional Development through workshops and conferences to keep up with the latest advances in research and treatment.
You can go onto the BABCP therapist directory on www.cbtregisteruk.com to search for a therapist near you. All the therapists you will find on here have accredited status. If you have a therapist’s name and want to check whether they are accredited or not, you can also do so here.
Joining the register is an individual therapist’s decision, so it is possible for a therapist to have the right training and qualifications and not be on it. Using the register simply cuts out the need to ask for and research their qualifications.
Second, you need to make sure that you choose a therapist that specialises in the treatment of OCD. This means a therapist that is experienced in delivering CBT with ERP. You can ask a therapist to have a conversation over the phone to discuss what you are looking for before you agree to meet with them.
You can ask them things like…
· What is your experience in treating OCD?
· Will you work with me to set out an individual treatment plan based on the specifics of my OCD?
(Rather than using the same structure or techniques with everyone)
· Will we set goals for treatment together? (Rather than therapist setting all the goals)
· Will my ERP plan use a ‘graded exposure’ method?
· Will you set practical tasks for my ‘homework’ and help me understand and take part in these
· Will you support me to better understand and challenge my OCD, rather than just taking part in
· Would you be willing or able to have some sessions within the area where I have most difficulty
(e.g. my home)?
You can also refer back to our CBT checklist on www.ocdaction.org.uk/support-info/have-i-had-cbt-my-ocd to make sure that the therapist mentions a similar treatment course. You can also talk through this checklist with a possible therapist to see how they feel about offering therapy like this.
How can I know if the therapy is working?
You and your therapist, after a certain amount of sessions, should also freely discuss the progress they feel you are making and the progress you feel you are making.
It is important that you be honest with one another and with yourself. If the therapist feels like not enough progress has been made, you may have to push yourself a little more. However, if you feel like you are giving it your all and that the therapist is lacking in terms of understanding, supporting you, or being positive, this may be a sign that your therapy partnership has gone as far as it can. In this case you may talk through some options and you may opt to seek a new therapist. Do not consider this a failure, the work you’ve done so far may have helped you in ways you can’t see yet.