OCD Treatment Programme

Monnica Williams (University of Ottawa), Ph.D., C.Psych., Registered Clinical Psychologist, authorized by the College of Psychologists of Ontario to practice clinical psychology with adolescents, adults, and organizations.

Cleaning man with OCD.

About Obsessive-Compulsive Disorder

Obsessive-Compulsive Disorder (OCD) is a psychiatric mental disorder characterized by obsessive thoughts and compulsive behaviours that significantly interfere with normal life. Obsessions are unwanted, recurrent, and disturbing thoughts that the person cannot suppress and that can cause overwhelming anxiety. Compulsions are repetitive behaviours that the person feels driven to perform to reduce the anxiety of the obsessions. The obsessive and compulsive rituals can occupy many hours of each day.

There are many disorders that have been mistakenly labeled as OCD. Some of them are the eating disorders, compulsive shopping, kleptomania, trichotillomania, and body dysmorphic disorder. Whilst there are similarities between OCD and these other disorders, there are also significant differences. Similar disorders that are not in fact OCD may be identified as OCD Related Disorders. Some of them require similar treatment, but for others the treatment is different. In addition, people with OCD frequently suffer from mood disorders, such as depression or bipolar disorder, as well as OCD.

Sometimes people wonder if OCD always includes both obsessions and compulsions. Approximately 80 percent of patients diagnosed with OCD have identifiable obsessions and compulsions. About 20 percent seem to have only obsessions or only compulsions. When people seem to have only obsessions, it is sometimes called "pure o" for "purely obsessional", however in these cases people do have compulsions, but they are hidden or subtle.

Cognitive Behavioural Therapy for Obsessive-Compulsive Disorder

Treatment Overview

The most effective OCD treatment programme includes psychoeducation, treatment planning, exposure and ritual prevention activities (EX/RP also called ERP), relapse prevention training, and home visits as needed. The programme as developed and delivered by Dr. Williams typically includes the following components:

  • 1 comprehensive evaluation: This is a 2-3 hour session where you will receive an in-depth clinical interview to review all of your symptoms and provide a diagnosis. This can be done over two sessions for local clients.
  • 2 treatment planning sessions: During these sessions we review your OCD symptoms in detail and develop a hierarchy to guide the treatment process.
  • 15 treatment sessions: These sessions are focused on activities to reduce obsessions and compulsions; you will do an exposure exercise in session that will be assigned for practice at home.
  • 2 family sessions (if applicable): If your family has been a part of your OCD, family sessions will be administered to help household members understand the disorder and learn what they can do to help.
  • 2 follow-up sessions: These will take place 3-4 weeks after treatment to address any lingering difficulties and ensure maintenance of gains.

If your OCD is severe, you may need ongoing follow-up after the treatment programme. For those coming from out of the Ottawa area, help will be provided to help locate a local provider for your follow-up care, if you don't already have one. Alternately, follow-up sessions can be done by phone. Follow-up for severe cases is typically weekly for 3 months.

Treatment Format

Treatment is usually delivered in two 60-90 minute (double) sessions per week. For people coming from out of the Ottawa area, intensive treatment is offered, which is generally daily 90-120 minute sessions over a 7 day period (including weekends), followed by 10 onine sessions. Family sessions are 50 minutes. Follow-up sessions are 30 minutes. Also you should anticipate up to 2 hours of homework each day. Most sessions are in person, but phone or videoconference may be used on an as-needed basis.

Effectiveness of Treatment

There is no cure for OCD, but clients can generally expect quick reductions in distress and an eventual return to normal behaviours. Clients who attend sessions and do the homework will typically make great improvements, and those who do not follow the programme will experience less improvement. For most people, this type of treatment is more effective than medication for OCD. However, some people will require both medication and the treatment programme for maximum results.

Cost of Treatment

Send email to inquire, and be sure to include your location. An initial phone or online consultation is also available.