OCD is a disorder characterized by unwanted and intrusive thoughts (obsessions) and repetitive behaviors (compulsions) performed to reduce the distress of obsessions. Common obsessions include contamination, aggressive impulses, and symmetry, while common compulsions include excessive washing, checking, and ordering. The disorder is diagnosed using DSM-IV criteria which requires either obsessions or compulsions that are time-consuming and cause distress or impairment.

1. OCD: Implications for Counselling Karen Boileau, Ashlee Ellerbruch, Maria Elsdon, Meagan Keashly, & Kim Long

2. Overview History of OCD Defining OCD Cognitive Behavior Theory Models of OCD Behavioral Cognitive-Behavioral Belief and Appraisal Interventions for OCD Medication Cognitive Behavior Therapy Exposure Response Repetition Implications for Counselling

3. A Peek at OCDExamples of Obsessionsand Compulsions A woman spends hours in the shower washing her body in a sequence that has to be the same each time. She will use a towel only if it is handed to her directly from a dryer and has not touched anything An aunt will not babysit for her nieces because she is afraid she will stab them with a knife as they sleep For five years a woman has been washing her arms up to the elbow 50 times a day until they are raw because she is worried that her germs will infect her family A man covers everything with a paper towel before touching it. If anything is touched by his clothes, he has to wash it. He can barely use his left hand because he is reluctant to let it touch anything Examples from: Obsessive Compulsive Disorder, 1998

4. History of OCD

6. The median age of onset is about 19 years old

7. Women account for 60% of adults with OCD

9. Examples of obsession (in order of most to least common): contamination, aggressive impulses, sexual content, somatic concerns and the need for symmetry.

10. Compulsions are repetitive and intentional acts or thoughts

11. typically these actions tend to reduce distress and they are quite excessive

12. Example: May be performed in response to an obsession. Or are performed according to certain rules (usually having to do with a pattern or set of numbers) Barlow & Durand, 2005; Obsessive Compulsive Disorder, 1998

14. Recurrent and persistent thoughts, impulses or images that cause anxiety or distress

15. These thoughts, impulses or images are not just excessive worries

16. The person attempts to neutralize these with some other thought or action

17. the person recognizes that the thoughts, impulses or images are a product of their mind

18. Compulsions

19. Repetitive behavior or mental acts that the person feels driven to perform

20. The behaviors or mental acts are meant to try and reduce distress or prevent some dreaded event or situationB. The person recognizes that the obsession/compulsions are unreasonable or excessive C. The obsessions/compulsions are time consuming, or interfere with a daily routine D. If the person has another Axis I diagnosis the content of the obsessions/compulsions is not restricted to it E. The obsessions/compulsions that are disturbing the person are not due to effects of a substance or general medical condition Reference: APA, 2000