This document discusses major approaches to treating obsessive compulsive disorder (OCD). It outlines biological, psychological, social, cognitive, and behavioral approaches. For each approach, it describes the underlying theories, techniques and strategies used, specific treatment strategies like medication and cognitive behavioral therapy, and the effectiveness of each approach based on research. The document concludes that OCD is best treated using a biopsychosocial model with cognitive-behavioral therapy and exposure response prevention.
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A whittier week2clinicalpsy
1. Major Approaches to Clinical
Psychology
Obsessive Compulsive Disorder
Adonia Whittier
March 19, 2013
PSY/480
2. What is Obsessive Compulsive
Disorder?
Anxiety Disorder
Obsession with intrusive persistent thoughts, impulses,
or images
Compulsion to relieve stress through mental or physical
action
Hyperactivity in the orbital surface of the frontal lobe,
the cingulate gyrus, and the caudate nucleus
More Common in Males
3. Philosophical Origin of OCD
Biopsychosocial Approach
Biological
Psychodynamic
Social
Cognitive-behavioral psychotherapy
Cognitive Processes
Behavioral Theory and Pavlov’s Theory
4. Philosophical Origin of OCD (Cont.)
Humanistic Theory
Self Actualization
Family Systems Theory
Family Centered Therapy
Positive Psychology
Focuses on Healing and Happiness
5. Goals for Each Approach
Biological
Explains behavior through biological sources
Psychological
Behavior is caused by psychological need
Social
Behavior is influenced by others and the interaction with others
Cognitive
Thought processes cause behavior
Behavioral
Cause and affect cause learned behaviors
6. Techniques and strategies of each
approach
Biological
Medication
Surgery to remove any abnormalities
Psychological
Understand personality traits that may influence the behavior
7. Techniques and strategies of each
approach (cont.)
Social
Educate family to not support the behavior
Cognitive
Techniques to combat
Behavioral
Exposure response therapy
8. Specific Treatment Strategies
Biopsychosocial Approach
Medication
Education on disorder to family and individual
Cognitive behavioral psychotherapy
Talking Back
OCD Mapping
Exposure and response therapy
9. The Effectiveness of Each Approach
Based on Research
Medication
In conjunction to Cognitive Behavioral Therapy
Cognitive Treatment
Regaining control over thought processes
Behavioral Treatment
Daily Exposure Therapy
11. References
American Psychiatric Association. (2000). Diagnostic and statistical manual of mental
disorders (4th ed., text rev.). doi:10.1176/appi.books.9780890423349.
Behar, D. (2001). OCD in children and adolescents-A cognitive-behavioral treatment
manual. Community Mental Health Journal, 37(5), 462-463. Retrieved
from http://search.proquest.com/docview/228335159?accountid=35812
Breiter, H. C., Rauch, S. L., Kwong, K. K., & Baker, J. R. (1996). Functional magnetic
resonance imaging of symptom provocation in obsessive-compulsive
disorder. Archives of General Psychiatry, 53, 595–606.
Ellis, B. (2011). Humanism and morality. Sophia, 50(1), 135-139. doi:
http://dx.doi.org/10.1007/s11841-010-0164-x
Nishith, P. (1995). OCD treatment for the mental health professional. Journal of Cognitive
Psychotherapy, 9(4), 293-295. Retrieved from
http://search.proquest.com/docview/89069003?accountid=35812
Plante, T. G. (2011). Contemporary clinical psychology (3rd ed.). Hoboken, NJ: John
Wiley & Sons.
Editor's Notes
#3: Obsessive Compulsive Disorder (OCD) is listed in the Diagnostic and Statistical Manual for Mental Health (DSM-IV-TR). The obsessions are defined as persistent thoughts, impulses or images intrusively causing distress or anxiety (American Psychiatric Association, 2000). The thoughts, impulses, or images are more than excessive worries dealing with real life situations. The person tries to either ignore or repress the feelings with another thought or action. The person understands these feelings are produced by their own imagination and not imposed on them by another source. The compulsions are defined as repetitive behaviors such as hand washing, organizing, excessive cleaning or mental acts such as counting, praying or repetition of specific words to relieve the stress and anxiety. The behaviors can vary case to case but they are all aimed at relieving or reducing stress through either the mental action or physical action and are considered excessive abnormal behaviors. Biological factors have been proven to cause or be present in individuals suffering from OCD. There is hyperactivity in the orbital surface of the frontal lobe, the cingulate gyrus, and the caudate nucleus areas of the brain (Breiter, Rauch, Kwong, & Baker, 1996; Damsa, Kosel, & Moussally, 2009; Insel, 1992; Micallef &Blin, 2001). According to the American Psychiatric Association (2000), OCD is more common amongst males than females.
#4: The biopsychosocial school of thought is used to explain and treat OCD. Biologically the body contains less serotonin in a person suffering from OCD than a person of average mental health (Plante, 2011, p. 154). The biological perspective may explain the behavior if any sort of tumor of brain injury occurred triggering the OCD symptoms. If no brain injury is present then leveling out serotonin levels may be done through medications. Psychologically understanding the individuals personality and a the persons motivation to want a controlled clean environment. Depending upon the symptoms, psychological approach can exposes reasons why this behavior is occurring. From a social perspective, a person may be rewarded for their obsessive clean behavior causing the individual to maintain the behavior. The cognitive behavioral psychotherapy can explain many of the OCD symptoms as well. Cognitive psychology can explain a persons confliction to maintain OCD behavior. They tell themselves they cannot control the situation unless they clean or touch a certain item. The obsessive behavior is also explained through behavioral theories. Behaviorally a person may feel the anxiety relief after participating in an obsessive behavior. Also a person is often triggered by a stimulus to perform an OCD behavior or response. This stimulus-response theory is based on behaviorism and the Pavlov’s theory.
#5: Humanistic theory is centralized on the belief that all people are born with good utilitarian morals and free will influences human behavior (Ellis, 2011). Humanistic theory claims a persons subjective thoughts are more important than objective thoughts. Every persons has potential to be the best person they can through self actualization. Psychological growth, fulfillment, and contentment are achieved by self-actualizing. Family systems theory focuses on healing the family as a whole. The family unit and systems within a persons life are important to this theory. The systems must work together to heal the disorder or negative behavior patterns. Positive psychology focuses on healing and the well being of the individual. This theory strives to focus on the changeable parts of life that can become more fulfilling. Disorders and problems such as OCD may not be the focus of their treatment, but bringing more happiness into that persons life could be beneficial.
#6: The Biological approach explains behavior as being a result of biological or bodily imbalances or problems. Biological approach explains behavior as being directly linked to irregular hormone levels, irregular levels of neurotransmitters, brain injury, tumors, or other bodily functions. Psychological approach uses Sigmund Freud’s psychodynamic approach and coping mechanisms to explain behavior. The psychological approach has a wide scope of theories to describe behavior. The social approach expounds behavior as being caused by social situations. The ideas of conforming, stereotyping, the self concept, discrimination, social influence, and peer pressure are often associated with the social psychological approach. Cognitive approach deals with the inner thought processes. Conscious processes such as perception, attention, memory, and thought. The cognitive psychologist wants to understand how a person perceives information and how it is processed. Behavioral school of thought explains behavore as response to stimuli. Behaviorists theorize that human babies are a clean slate without personality or behaviors. The behaviorist explains all behaviors as a reaction to learned behaviors due to reward systems and punishment responses to the behaviors. Each of these approaches has its own distinct set of theories to explain OCD and make a complete analysis of the disorders initial origin.
#7: Techniques and strategies of each approach vary depending upon the philosophical origin of OCD. The Biological theory focuses upon using medication and removing any areas of the brain that have tumors or abnormalities. Medication is used to control behavior by correcting imbalances with brain chemistry. Biological method focuses on the synaptic receptors of the brain and the neurotransmitters within the brain. Psychological approaches include a wide variety of theories. The theories are based upon topics such as repression, coping mechanisms, the ego, and many other psychodynamic topics. The psychological approach brings about an understanding of personality traits, life stages, and unconscious motivations.
#8: The social approach to psychology uses education as a tool for families. Families must understand they cannot support behaviors that are unhealthy. Social aspects can include concepts such as racism, discrimination, peer-pressure, enabling, and normative social influence. These topics can influence behavior dependent upon the setting. Cognitive technique involve changing patterns of thoughts or opinions a person has of themselves, others, or their environment. Awareness of disorders through cognitive therapy can cause individuals to consciously change how they process information (Nishith, 1995). Behavioral strategies use stimuli and responses to control and influence behavior. Rewarding an individual when they behave positively causes reinforcement of the behavior. Punishment for negative behaviors is used to weaken the response and eliminate bad behaviors. Operant behavior theory and the basis of all exposure response therapies is based upon B.F. Skinners work.
#9: The biopsychosocial approach uses a combination of medication and education to help the individual with the OCD symptoms. Understanding what the body is doing that drives the individual may help the individual understand their problem more. Also educating the individual on all the aspects of the disorder described by the various theories can greatly improve awareness of the behavior. The use of cognitive behavioral psychotherapy creates coping mechanisms and techniques to control the obsessive behavior and the stress associated with the compulsions. Talking back to the compulsion and not let the OCD boss you around is one technique (Plante, 2011, p. 154). Also using OCD mapping to gather more information on the specific triggers of the compulsion can help formulate a treatment strategies based upon the interaction with the stimulus. Exposure and response therapy involves exposing an individual to what triggers the compulsory behavior (Plante, 2011, p. 155). Exposing a person with an aversion to dirt and showing them that realistically there is nothing to fear if they do not wash their hands right away. Calming the person while exposing them to the stimulus is most important.
#10: Research can successfully validate treatment plans from empirical data collected on the techniques and results from treatment plans. The use of medication has been used in many severe cases and has helped with irregular serotonin levels (Plante, 2011). Medication such as all SSRI's or clomipramine are used with a Cognitive Behavioral Therapy is best for children because they often cannot overcome physical impulses or reactions like adults (Behar, 2001). Self control is always harder for children since adults have practice with this through life experience. However, there are many treatment plans that use the many psychological approaches. Using cognitive treatment to gain control of the thought processes can alleviate stressors and help bring awareness to the behavior as it is occurring (Nishith, 1995). Awareness of what drives the person to have compulsory behavior can help the person consciously deal with the behavior and stress (Plante,2011). Behavioral treatment uses the exposure on a daily basis to lower the aversion to a stimulus. A person must do this on their own with directions from a trained professional. These many types of treatment are affective based upon empirical research. There are many treatment plans that involve multiple step programs to incorporate medication and behavioral-cognitive treatment and have been proven to be the most affective in children and with adults (Behar, 2001).
#11: Psychologists use biological perspectives, psychoanalytical theories, social psychology, cognitive therapies, and behavioral therapies to explain OCD. Medications are used to level out chemicals within the brain to lessen physical symptoms. The use of psychoanalytical theories explains many different personality influences and motivations by internal processes. Social psychology concepts are used to understand peer influence or reinforcement through family systems. Cognitive therapies combat negative thought processes through gaining control of cognitive processes. Behavioral therapy uses exposure and response therapy to combat aversions and obsessive behaviors through reconditioning. These perspectives are used to formulate an accurate assessment of an individual with OCD.