WHAT IS TREATMENT LIKE?

Treatment is tailored to each individual, depending on a variety of factors.  While every course of therapy is unique, our practice is rooted in evidence-based treatment. Check out some of the modalities commonly used at Bull City Anxiety & OCD Treatment Center:

Cognitive Behavioral Therapy (CBT) is an evidence-based practice that has been empirically shown to be effective for a variety of diagnoses. CBT is based on the idea that our unwanted feelings (sadness, fear, anger, etc.) are a product of our thoughts (cognitions) and our behaviors. The goal of therapy is to identify thoughts and behaviors that are getting in the way and to implement changes in order to improve functioning.  

Exposure and Response Prevention (ERP) is a component of CBT and is the gold-standard of treatment for OCD. It is a behavioral therapy in which individuals practice confronting feared stimuli while resisting the corresponding compulsions; for example, touching a doorknob, then resisting the use of handwashing. Traditionally, individuals create a fear hierarchy, progressively moving from less- to more-feared stimuli once an individual has habituated to each exposure.  ERP works most effectively when practiced regularly. We guide individuals through exposures in session, but also assign ERP homework to be completed between sessions.  

Acceptance and Commitment Therapy (ACT) is what’s known as a “third wave” therapy – a derivative of CBT much like DBT or MBCT.  Rather than focus on the elimination of symptoms, ACT is a tool to facilitate the pursuit of a meaningful, value-filled life, even if doing so may sometimes involve feeling unwanted feelings. ACT encompasses skills like mindfulness and thought defusion, while also helping individuals to increase willingness to pursue their goals in the face of distressing feelings. ACT can also be used as an adjunct to CBT – while we strive to help individuals reduce distressing symptoms, we also know that there is no magic pill to immediately remove bad feelings and that some people may benefit from learning tools to facilitate this process. The name of this therapy references “accepting” unwanted feelings, while concurrently “committing” to valued action.  

Inference-Based Therapy (referred to as both ICBT and IBT) is a process-based treatment for OCD that addresses reasoning errors which perpetuate OCD.  In ICBT, OCD is attributed to inferential confusion — when you become immersed in your imagination and begin making decisions based on faulty reasoning.  ICBT provides tools to help you to disengage from imaginal absorption and to refocus on evidence in the here and now. 

Metacognitive Therapy (MCT) is a treatment modality that addresses cognitions, though unlike traditional CBT, MCT does not seek to dispute or reframe cognitive distortions.  In fact, MCT is not concerned with the content of your thoughts at all.  Rather, it looks at your beliefs about your thoughts.  Do you catastrophize the presence of unwanted thoughts?  Or believe that they’re harmful or meaningful?  Do you fall into the trap of assuming that your worry is necessary to keep you safe?  MCT can help you to address unhelpful beliefs about thoughts by building awareness of these patterns and establishing more adaptive approaches to managing  internal experiences. 

Habit Reversal Therapy (HRT) and the Comprehensive Behavioral Model (ComB) are both evidence-based treatments for body-focused repetitive behaviors like trichotillomania or skin-picking disorder.  HRT involves awareness training and developing competing responses which are incompatible with the BFRB.  ComB expands on HRT by focusing on functional assessment, seeking to understand the context for these behaviors — identifying the thoughts, feelings, circumstances, and actions that drive each individual's BFRB.  Interventions are then tailored to fit the array of factors contributing to the maintenance of the BFRB.