For the treatment of OCD and other severe anxiety disorders, Rogers Memorial Hospital uses a strict Cognitive-Behavioral Therapy (CBT) approach. This is not "talk therapy", but a skill learning approach.

For OCD, the main emphasis is a technique called Exposure and Ritual Prevention (ERP). ERP has been found to be the "treatment of choice" for OCD. Exposure refers to the gradual and repetitive exposure of an individual to their feared situations (e.g., someone with contamination obsessions touching a doorknob), or ideas (e.g., someone with contamination obsessions thinking about AIDS). Exposure work targets the obsessions, and seeks to prolong the obsessional thought, image, or impulse long enough for the process of habituation to occur. Habituation is the natural, normal process of anxiety levels reducing with nothing more than the passage of time. Research has shown that 97% of people experience the process of habituation. Ritual Prevention is the blocking of the ritual or compulsion that would normally be performed upon exposure (e.g., hand washing, checking).

In addition to ERP, cognitive restructuring strategies are also taught. Cognitive restructuring or "thought challenging" is the identification and correction of "errors" in thought that create anxiety. Two errors in thought most focused on are "probability overestimation errors" and "catastrophizing errors." A probability overestimation error is when someone overestimates the likelihood of a bad event happening (e.g., the house will burn down if I don't check the stove). A catastrophizing error is when someone blows out of proportion, magnifies, or catastrophizes how bad fairly likely events really are (e.g., dropping something on the floor for someone with contamination obsessions).

The hierarchy is a list of graduated exposures ranging in severity from 0 to 7. The goal is to gradually expose you to all of your fears until you no longer experience anxiety. The hierarchy is developed through a detailed assessment. Once the hierarchy is developed, it directs the development of an individualized treatment plan.

Many individuals with anxiety disorders respond well to a combination of medication and CBT. Research has shown that head to head CBT can be as effective as medications but combined can produce even more positive outcomes. Unlike with the use of medications where symptoms can come back if you discontinue the medication, the positive results of CBT are not lost. We do have a skilled psychiatrist to evaluate and monitor the use of medications.

As a general rule, yes, but there will always be exceptions due to other co-existing conditions and one's motivation. This is hard work for the patient, but one with high rewards.

The items that you can and can't bring vary depending on which center you will be staying in. As part of your orientation to the unit, staff will thoroughly check all of your belongings when you arrive. Any inappropriate items will be returned to your family or secured by Rogers Memorial staff until your discharge.

• The Obsessive-Compulsive Disorder Center
  Click here for a list of mandatory, recommended and optional items you may bring, as well as items that are not allowed during your stay. If you have any questions after reading the list, please contact our admissions department.