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Getting the Most Out of Psychological Treatments for OCD
Change Is a Process, Not a Destination

By Owen Kelly, Ph.D., About.com

Updated: February 15, 2009

About.com Health's Disease and Condition content is reviewed by the Medical Review Board

Long-lasting Change Requires Readiness for Change

Whether it is quitting smoking, starting a new diet or beginning a new workout routine, almost everyone has struggled at some point with making positive changes that should become permanent.

Engaging in cognitive-behavior therapy (CBT) for managing symptoms of OCD is no different. It requires hard work and dedication to maintain the gains you’ve made during therapy. For many, just beginning therapy is half the battle as it often requires facing your worst fears.

Psychological treatments for OCD appear to work best for those individuals who are ready for change and understand how change works. It is important to realize that change is a process, not a destination. Once you’ve arrived at your goal, the hardest work is often yet to come.

The Five Stages of Change

Positive changes in symptoms or troublesome behaviors rarely take place overnight; in fact, changes in these behaviors usually take place in a series of gradual steps.

  • Stage 1: Precontemplation – you have no intent to change your behavior within the next six months. You are likely to find yourself in this stage if you feel your OCD symptoms are not severe enough to be cause for concern.

  • Stage 2: Contemplation – you are aware that the problem exists but have not yet committed to taking action. Often people are aware there is a problem but fear seeking help or taking action as it may confirm their worst fears; however, in the long run, this can make things much worse.

  • Stage 3: Preparation – you have committed to take action in the near future and may have even started making some small changes in your behavior. This could involve something as simple as calling a doctor or psychologist for an appointment to begin psychotherapy or other forms of treatment.

  • Stage 4: Action – you are spending a lot of time and energy engaging in behavior modification, and major changes in behavior are starting to take shape. Most individuals just beginning CBT therapy are in this stage.

  • Stage 5: Maintenance – you are working to prevent a relapse of symptoms and consolidate your gains. This stage applies when you are well into CBT or once therapy has finished. The goal of CBT is to provide you with tools that you can use on your own once therapy has finished.

Relapse Is Normal

Setbacks are inevitable when trying to change our behavior or reduce symptoms. Don’t be too hard on yourself if your OCD symptoms suddenly worsen or if you forget to do your CBT homework for a day or two. Unfortunately, people can become so discouraged over a single setback that they decide that failure is inevitable and abandon all the hard work they’ve put in. It can often be helpful to maintain a diary or log of your progress. When you are feeling down or discouraged it can be very useful and motivating to look back at how far you’ve come.

Source:

Prochaska, J.O., & DiClemente, C.C. “Stages and processes of self-change of smoking: Toward and integrative model of change”. Journal of Consulting and Clinical Psychology 1983 51: 390-395.

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