Obsessive Compulsive Disorder - Treating OCD with Cognitive Behavioral Therapy

Written by HealthyPlace.com Staff Writer

pahillsburtner: Dr. Claiborn, can hoarding be effectively managed without the professional coming to the home?

Dr. Claiborn: Most people with a hoarding problem will not be able to manage it without some professional help. From what we have seen, medication will usually not be a big help. If the professional can't come to the house, sometimes a friend can help. Usually, families are in such conflict with the hoarder, that their attempts to help don't work.

lorianne: My type of OCD is scratching and picking my skin and it is so embarrassing that I can't wear short sleeves or shorts since I do it on my arms and legs. I am wondering if any of the books you mentioned might be helpful to me. There are times when I have let myself heal with only a few areas affected. I forgot to mention that I have been on Luvox 200 mg every day for about 4-5 months.

Dr. Claiborn: The skin picking problem is not the focus of most of the work on OCD, so there is not that much help for it. I actually wrote a self help manual for it and have given it out by This e-mail address is being protected from spambots. You need JavaScript enabled to view it ever since. There is an email list devoted to it which you could look into. You can also look at the material on treating trichotillomania (hair pulling), as that is very similar.

thinman99: What do you know about treating Down Syndrome people with OCD? My son has developed this during his transition from home to the workplace. He seems very anxious and all he wants to do is stay home. It is hard for him to express his feelings because of his retardation but he is a high to moderate functioning Down's young adult.

Dr. Claiborn: I have not worked with this population very much but I would think that in many ways the same sort of adjustment we make to treat children would work for a Down's syndrome adult. You could look at March and Mulle's book, OCD in Children and Adolescents : A Cognitive-Behavioral Treatment Manual, for a start.

David: Now, Dr. Claiborn, I'm getting some questions about how people can get your self-help book.

Dr. Claiborn: They can email me. Anyone interested in self help on skin picking and related problems can email me at This e-mail address is being protected from spambots. You need JavaScript enabled to view it and just ask. I will send it to you as an attachment.

SarahKatz: My husband has a fairly severe form of OCD. The psychiatrist that has been treating him is retiring. What suggestion do you have for selecting a new doctor? It took me years to get him to agree to any treatment. He still refuses CBT but the Prozac he takes does help.

Dr. Claiborn: Most psychiatrists these days know enough about OCD to manage the medications. You may be able to find a specialist by contacting the Obsessive Compulsion Foundation and asking for a referral list for your area. You can also get him some information about CBT and he may be willing to try.

chat: Do you have any recommendations to finding a good therapist who treats OCD?

Dr. Claiborn: I could start with the Obsessive Compulsive Foundation as they have a list of people who treat OCD. There are other professional organizations to try as well, such as the association for advancement of behavior therapy. I also recommend asking lots of questions before committing to treatment. The therapist should mention things like exposure and ritual (response) prevention or CBT. If they don't ask, or if they say they want to do something else, keep moving.

Rypax: Dr. Claiborn, I have an Obsession that I want to molest my daughter. I know that this is common and I am doing better with it, but how do I get over the feeling that I want to do this?

Dr. Claiborn: If it is a typical obsession, the idea seems horrible to you. You want it to go away. You think it means something awful that it comes to mind. The efforts to keep it out of your mind are part of the problem. Accept that this and other strange ideas come into everyone's head. There is nothing strange about having the idea. Do allow it to pass thru your mind and do not do anything to prevent it from happening, like leave the room, pray, ask for reassurance, or whatever. The final effect is that your obsession loses its power.

David: You mentioned earlier that genetics may have something to do with OCD. Does OCD seem to run in families and can it be passed on from parent to child?

Dr. Claiborn: The observation is that it does run in families, and that if a parent has it, the odds of their child having it are somewhat higher than in the general population. However, not so high that it is a sure thing. The genetics is one area that is being studied these days.

Dave1: Are there any special schools (even boarding) that handle teens with OCD?

Dr. Claiborn: I don't know of special schools and under most circumstances this would not be needed. If a teen has severe OCD, I would recommend a trial of intensive treatment and probably medication. Then, they can go back to school at their regular school with some special help.

David: Are there a lot of people with OCD who self-medicate, meaning taking alcohol or drugs to relieve their symptoms?

Dr. Claiborn: It is likely that in both teens and adults, alcohol and drugs are used as self-medication. It is hard to know until you get them substance free. We know that panic disorder is associated with high rates of substance abuse as a self-medication, and OCD may be similar.

luvwinky: Can you tell me anything about Tofranil (Imipramine)? My psychiatrist wants to try this medication on me.

Dr. Claiborn: Tofranil is a tricyclic antidepressant. It is a fine antidepressant, but I would not expect it to do anything for OCD.