8 added country
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Unfortunately, there is, in the U.S. at least, a severe national shortage of therapists trained in diagnosing and treating OCD and specific phobias, but the good news for you is that it's easier to find someone who can treat adults than children. Take a look at the International OCD Foundation website.

Unfortunately, there is a severe national shortage of therapists trained in diagnosing and treating OCD and specific phobias, but the good news for you is that it's easier to find someone who can treat adults than children. Take a look at the International OCD Foundation website.

Unfortunately, there is, in the U.S. at least, a severe national shortage of therapists trained in diagnosing and treating OCD and specific phobias, but the good news for you is that it's easier to find someone who can treat adults than children. Take a look at the International OCD Foundation website.

7 clarified the process
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In the first treatment session, my son described specific OCD symptoms he experienced, and the therapist wrote them down. In the second session, he ranked the items on the list according to how impairing they were. These two steps together are called "mapping the OCD". In the third session they selected one of the least impairing symptoms and constructed a homework exercise. In my son's case, the first symptom chosen to work on was this: when my son walked past a dandelion flower, he felt an overwhelming urge to pick it and flick it away with his index finger. So the exercise was to go outside once a day, find a dandelion in bloom, and stand there looking at it, without picking or flicking, and record on his homework grid his "temperature", i.e. how strongly he felt the urge to perform the ritual. You record your temperature at intervals. Eventually your "temperature" starts to go down, because your body can't maintain the heightened alert state all afternoon. The grid we were given to work with suggested time points (in minutes) of 1, 2, 5, 10, 15, 20, 25, 30. However, my son's inner clock runs fast, and we found that the suggested pace was too slow for him. We found that generally, his "temperature" starts to go down after about 20 seconds. Sometimes, we see that it goes up again before it really tails off -- in other words, we see a two-humped curve. But as long as we haven't bitten off more than he can chew, it really does always tail off. The key is to go very step by step in the sequence of exercises.

You go through the exercise every day. After a few days, or a week, we found that it would start to get easier.   My son was usually ready to move to the next exercise in the sequence after about 10 days.

In the first treatment session, my son described specific OCD symptoms he experienced, and the therapist wrote them down. In the second session, he ranked the items on the list according to how impairing they were. These two steps together are called "mapping the OCD". In the third session they selected one of the least impairing symptoms and constructed a homework exercise. In my son's case, the first symptom chosen to work on was this: when my son walked past a dandelion flower, he felt an overwhelming urge to pick it and flick it away with his index finger. So the exercise was to go outside once a day, find a dandelion in bloom, and stand there looking at it, without picking or flicking, and record on his homework grid his "temperature", i.e. how strongly he felt the urge to perform the ritual. You record your temperature at intervals. Eventually your "temperature" starts to go down, because your body can't maintain the heightened alert state all afternoon. The grid we were given to work with suggested time points (in minutes) of 1, 2, 5, 10, 15, 20, 25, 30. However, my son's inner clock runs fast, and we found that the suggested pace was too slow for him. We found that generally, his "temperature" starts to go down after about 20 seconds. Sometimes, we see that it goes up again before it really tails off -- in other words, we see a two-humped curve. But as long as we haven't bitten off more than he can chew, it really does always tail off. The key is to go very step by step.

You go through the exercise every day. After a few days, or a week, it would start to get easier.  

In the first treatment session, my son described specific OCD symptoms he experienced, and the therapist wrote them down. In the second session, he ranked the items on the list according to how impairing they were. These two steps together are called "mapping the OCD". In the third session they selected one of the least impairing symptoms and constructed a homework exercise. In my son's case, the first symptom chosen to work on was this: when my son walked past a dandelion flower, he felt an overwhelming urge to pick it and flick it away with his index finger. So the exercise was to go outside once a day, find a dandelion in bloom, and stand there looking at it, without picking or flicking, and record on his homework grid his "temperature", i.e. how strongly he felt the urge to perform the ritual. You record your temperature at intervals. Eventually your "temperature" starts to go down, because your body can't maintain the heightened alert state all afternoon. The grid we were given to work with suggested time points (in minutes) of 1, 2, 5, 10, 15, 20, 25, 30. However, my son's inner clock runs fast, and we found that the suggested pace was too slow for him. We found that generally, his "temperature" starts to go down after about 20 seconds. Sometimes, we see that it goes up again before it really tails off -- in other words, we see a two-humped curve. But as long as we haven't bitten off more than he can chew, it really does always tail off. The key is to go very step by step in the sequence of exercises.

You go through the exercise every day. After a few days, or a week, we found that it would start to get easier. My son was usually ready to move to the next exercise in the sequence after about 10 days.

6 added: how to find thereapist who can do ERP
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Addition about how to find a therapist who can do ERP, if one is interested in pursuing that treatment modality (copied from the comments):

Unfortunately, there is a severe national shortage of therapists trained in diagnosing and treating OCD and specific phobias, but the good news for you is that it's easier to find someone who can treat adults than children. Take a look at the International OCD Foundation website.

When I was having trouble finding someone, I called up the OCD Foundation, and amazingly enough, their executive director took my call himself, and got me unstuck. One thing to watch out for: in my geographical area, at least, for every therapist trained in doing ERP, there are at least 10, maybe even 100, who will blithely say they can diagnose and treat OCD, despite never having been to a single workshop on ERP. However, ERP is the only therapeutic treatment that holds up in studies.


Addition about how to find a therapist who can do ERP, if one is interested in pursuing that treatment modality (copied from the comments):

Unfortunately, there is a severe national shortage of therapists trained in diagnosing and treating OCD and specific phobias, but the good news for you is that it's easier to find someone who can treat adults than children. Take a look at the International OCD Foundation website.

When I was having trouble finding someone, I called up the OCD Foundation, and amazingly enough, their executive director took my call himself, and got me unstuck. One thing to watch out for: in my geographical area, at least, for every therapist trained in doing ERP, there are at least 10, maybe even 100, who will blithely say they can diagnose and treat OCD, despite never having been to a single workshop on ERP. However, ERP is the only therapeutic treatment that holds up in studies.

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