Steve Turnock 25/01/2023 Steve Turnock 25/01/2023

OCD in the workplace

Obsessive Compulsive Disorder (OCD) is a much misunderstood mental health problem. It affects about 1.2% of the UK population, or approximately 750,000 people. OCD symptoms tend to vary from person to person. They can include intrusive, unwanted, and difficult to control thoughts, images or urges (obsessions) relating to harm/danger, contamination, sex, religion, need for symmetry or exactness, and acts that are repeated physically or mentally (compulsions or rituals) such as cleaning/washing, checking, counting, ordering and many other repetitive behaviours.

OCD can affect people in different ways. Whilst it is true that obsessive doubts about harm or aggression and fears of contamination with their associated compulsions account for 62% of OCD behaviour, these are not the only manifestations of such a common, long-standing, and debilitating mental health problem as OCD. For example, excessive need for symmetry or exactness (10%), and religious (6%) and sexual (6%) are also common.

What does this mean for someone in the workplace who suffers with OCD? In some instances, triggers of a person’s OCD may not occur in the workplace, and as such, their behaviour may not appear unusual.

However, this may not be the case for someone who has OCD where the trigger for their OCD is apparent in the workplace. For these people, their behaviour may appear unusual, and their productivity may be affected. Certain tasks may take longer than usual. Colleagues may not understand why the person with OCD is behaving in a certain way. The person with OCD may even be subject to criticism and even jokes or ridicule.

In both cases though, whether potential triggers to OCD either are or aren’t in the workplace, they will potentially have one thing in common, tiredness. OCD is a debilitating disease that often leads to compulsions, which can be very repetitive, time consuming, and very tiring. That tiredness can be carried through into the workplace. For example, I have met an OCD sufferer that regularly took 3 hours to get to bed each night, due to the repetitive checking rituals that they performed. It could also take 1 to 2 hours to leave the house!

In many instances, OCD sufferers will be late for work or absent from it. One study suggested that on average, someone suffering with OCD, may have as many as 46 days absence from work per year. I have been retired now for many years, but I know that in my own journey with OCD, when my OCD was at its worst, there was no possible way in which I would have been able to function at work. I was barely functioning outside work!

People with OCD who are looking for work, may also find it more challenging. Just the act of searching or applying for jobs or even attending interviews in a healthy mental and physical state can be a challenge. I myself had to stop driving for 6 weeks when my OCD was at its peak.

Thankfully, help is at hand. At Asto Clinics we offer a 12 week, online, Group Therapy Programme, which consists of Cognitive Behavioural Therapy (CBT) and Exposure Response Prevention (ERP). ERP is a process where you learn to effectively face your fears in order to overcome OCD.

The combination of CBT with ERP is a clinically proven method for the effective treatment of OCD. Our OCD Treatment Programme consists of 12, 2 hour online group sessions with a maximum of 10 people in a group. Each week our consultant clinical psychologist takes patients through the theory, and then sets exercises, or “homework” for the following week. As the weeks build, the knowledge of the patient grows, such that by the end of the programme, they effectively become their own therapist, and can then continue the work necessary to recover from their OCD.

Asto is already engaging with patients who are struggling to stay in work because of their OCD, or finding it challenging to find work.

Dr Costas Papageorgiou 06/07/2022 Dr Costas Papageorgiou 06/07/2022

“The Face with a Thousand Masks”

When people think of obsessive-compulsive disorder or OCD, they often think of people who excessively check things, such as doors or taps, perhaps in response to having thoughts/images (obsessions) about some impending danger, or people who excessively clean/wash themselves or different objects or surfaces as a result of having fears about contamination. Whilst it is true that obsessive doubts about harm and fears of contamination with their associated compulsions account for 62% of OCD behaviour, these are not the only manifestations of such a common, long-standing, and debilitating mental health problem as OCD. It is a well-known fact that the symptoms of OCD tend to vary from person to person and people experience other forms of obsessions such as: excessive concern with exactness, order, or symmetry (10%); worrying about the body or physical symptoms (7%); religious, sacrilegious, or blasphemous thoughts (6%); sexual thoughts or images, including fears of being a paedophile (commonly referred to as “P-OCD”) or homosexual (“H-OCD”) (6%); urges to hoard useless or worn out possessions (5%); and thoughts or images of violence or aggression (4%).

Unlike other mental health problems, such as clinical depression, OCD does not tend to be episodic but is instead a persistent problem, suggesting that over a period of time people with OCD are likely to experience different obsessions and compulsions. This may have led to some people to conclude that they “have had different types of OCD come and go over time”. The reality, however, is that people have continued to experience OCD and its fluctuating symptoms so the same “face” has remained but different “masks” have changed.

In our OCD Treatment Programme, we use the metaphor of a bottle as the OCD and the content of this bottle representing various obsessions and compulsions. Our goal is to help you learn to break the bottle, rather than empty it, so that there is no more room for other thoughts/images or behaviours to be replaced. By its own nature, OCD is likely to fluctuate over a period of time if it remains untreated and this may feel that it is changing to something else. However, the beliefs, attitudes and rules known to drive OCD are unlikely to reduce or change if not addressed directly with effective therapy. Most studies looking at what therapies are best for overcoming OCD have concluded that a specific type of cognitive-behaviour therapy (CBT), accessed either on a one-to-one basis or in a group, is the most effective treatment for this problem. Our 12-week Treatment Programme based on CBT may be able to help you “break the bottle”.

Dr Costas Papageorgiou 24/06/2022 Dr Costas Papageorgiou 24/06/2022

The Case for Group Therapy for OCD How Effective Is it?

In a previous article, we focused on trying to dispel common myths and perceived concerns about group therapy for obsessive-compulsive disorder (OCD), which is a common, usually long-standing, and debilitating mental health problem that tends to vary from person to person and consists of: (1) obsessions, defined as persistent intrusive, unwanted, and difficult to control thoughts, images, or urges relating to harm/danger, contamination, sex, religion, need for symmetry, and (2) compulsions or rituals, which are acts that are repeated either physically or mentally including cleaning/washing, checking, counting, ordering, and many other repetitive behaviours. The currently recommended psychological treatment for OCD is a specific type of cognitive-behaviour therapy (CBT), which helps individuals with OCD change the unhelpful patterns of thinking and coping behaviours that keep the problem going.

CBT for OCD has the highest degree of scientific support and whether this therapy is accessed on a one-to-one basis or in a group it does not affect the result. Therefore, despite some beliefs that people may have about benefitting more from individual CBT, the research has shown that this is not the case; group CBT is as effective as individual CBT. So, how effective is this group CBT for OCD? In a recent large-scale, real-world study conducted by the clinical team at Asto Clinics, it was found that between 64% and 86% of individuals with OCD who had participated in group therapy improved significantly after the 12-week treatment programme. The study also found that a new type of psychological treatment for OCD, called metacognitive therapy, that was introduced into the 12-week treatment programme had led to more participants improving. These results are comparable to the best results reported in previous scientific studies.

There were also some other important results to note about these group therapies. One particular aspect was the proportion of participants completing the 12-week treatment programme. This may seem irrelevant to most people because after all everyone is keen to get better and get rid of their OCD. Whilst this is the case, it is important to highlight that for a significant number of individuals receiving therapy for OCD, this form of treatment may be perceived as aversive although this is clearly not what is actually intended. That is why studies have shown that up to 32% of people attending therapy for OCD tend to drop out at some point before completing the intervention and gaining the full benefits. The large-scale study that was conducted by the Asto clinical team found that only up to 9% of their group therapy participants had dropped out and that those who did complete the 12-week treatment programme were 95% likely to recommend it to someone else with similar OCD.

Asto Clinics is a UK charity that was established by Steve Turnock who used to have long-standing OCD but managed to overcome it after attending a specific course of group CBT. The charity is dedicated to providing effective virtual group CBT for individuals with OCD. If you or someone you know is experiencing OCD, please make contact using one of the methods on our contact us page.. We are here to help.

Dr Costas Papageorgiou 14/06/2022 Dr Costas Papageorgiou 14/06/2022

The Case for Group Therapy for OCD Busting the Myths

Do you or someone you know have obsessive-compulsive disorder (OCD), which has been debilitating and not gone away despite several efforts? If so, please read this brief article as we might be able to help. OCD is one of the most common (1 in 50 of us), long-standing, and life-interfering mental health problems. The symptoms of OCD tend to vary from person to person. These can include persistent intrusive, unwanted, and difficult to control thoughts, images, or urges relating to harm/danger, contamination, sex, religion, need for symmetry, and acts that are repeated physically or mentally including cleaning/washing, checking, counting, ordering, and many other repetitive behaviours. OCD is often very challenging to manage not only for individuals who experience this problem, but also for healthcare professionals, families and carers trying to help those with OCD. Unfortunately, the idea that time is a good healer does not work much for OCD because in the absence of effective treatment, OCD can persist for many years causing disability and poor quality of life.

So, what psychological treatments work for OCD? Most studies looking at what therapies are best for overcoming OCD have concluded that a specific type of cognitive-behaviour therapy (CBT) is the most effective therapy for this problem. Importantly, scientific studies have also shown that CBT for OCD is equally effective whether it is accessed on a one-to-one basis or in a group. Despite this, some individuals initially hesitate to take part in group CBT for OCD because of some of their perceived concerns. Some typical questions include: “Would I have to talk to others in the group at great lengths about my problems? Because of my OCD, would I not need an individual therapist to spend a lot of time with me to unravel my issues? Would I catch other people’s OCD?” The answer to all of these common questions is no.

Group CBT for OCD does not work by just simply talking extensively with others but instead by doing “homework assignments” that enable individuals to change their unhelpful thinking and coping behaviours. That is why the severity or duration of OCD is not as important as how much people put into their treatment. Group CBT for OCD focuses on the here-and-now, on how to understand a common pattern of thinking and behaving that keeps OCD going and learn to overcome it, rather than focusing on the there-and-then, or past experiences, which can often make OCD worse and create a sense of hopelessness or helplessness. OCD is an anxiety disorder and not an infectious disease so being with others who have OCD does not make people “catch it”. Group CBT for OCD is like attending a “how to” class or course with other people who share the same goals. The ultimate objective of group CBT for OCD is to gradually help people become their own therapist but also ensure that the symptoms do not return.