Please can anyone recommend OCD help that actually worked?

[Suuudohnym]

Teen has seen an online psychiatrist and therapist in the past - neither really got to the root of the problem.

She has the type of OCD where she has to repeat rituals to feel “right”. She’s not yet at the stage where she can’t go to school/leave the house etc but it is getting worse and I don’t want it to come to that.

She’s feeling really anxious at the moment (I’m sure upcoming GCSEs don’t help) and is in tears as she just couldn’t feel right this morning.

We have private healthcare - who can I take her to in the SE/London who can really help her? Please help 😔

SSRI plus CBT with ERP is the standard treatment and is effective. I think online therapy is less good in this particular situation because you need to do exposure work and that’s better if the therapist is there in person. Has she tried those specific treatments and it didn’t work?

Thank you.

I agree, I’d much rather face to face help.

She’s never tried meds. Her last therapist did ERP in a sense - but it was more about tackling her compulsions one at a time. Which didn’t really work because she doesn’t have “set” compulsions - they often come to her in the moment - flicking a light switch multiple times, choosing the right tshirt to wear, repeating things in her head etc.

Also with ERP, I’m not sure what she would be “exposed” to because again, there’s no particular trigger. But we are very open to anything - I’d really love the name of a therapist/clinic if you have one? 🙂

The exposure would be to the feeling of not being right, and resisting doing the compulsions to rectify it.

Have you tried Camhs? The help my dd has from them is pretty good, although I am aware it can be hit and miss.

The Maudsley is apparently the specialist centre for OCD.

https://www.nightingalehospital.co.uk/obsessive-compulsive-disorder/

These guys are OCD specialists in London.

No real advice...dd had CBT as a teenager but then refused to engage. If it helps...she's now 30, has an amazing job and life...she still has OCD but can regulate it better.

According to my partner there is no effective treatment. He said therapy is designed by people who dont have ocd. He said it shouldn't be based around trying to avoid the rituals it will never work.

He's never beaten it in fact he seems to enjoy his rituals and doesnt care the impact they have on me.

Priory North London - OCD specialist help for young people

I watched a film about the inpatient unit at the Maudsley for OCD about 15 years ago. Patients seemed to improve.

It is for adults

OCD incredibly complex. I had the perinatal version (intrusive thoughts about doing horrible things to your baby- super fun!) and ended up in psych hospital

gradual exposure works - like climb a flight of stairs holding my baby with someone I trust, rather than stand by a top floor window with baby, which would destroy me and make me run away. Can you translate this gradual exposure with the help of professionals to your daughters situation?

Oh, yes - I forgot that. I am wrapped up with two adults with OCD. One so severe, that she won’t eat or drink half the time! She’s been sectioned, but they couldn’t make her eat or drink either.

Thank you all for your suggestions.

I have heard of the Maudsley - is it very inpatient focused? The idea of her being in hospital for this really upsets and scares me 😔

I’ve avoided CAMHS tbh because all I hear is that the waiting lists are for months?

I think it's definitely worth trying an SSRI, especially with GCSEs coming up. If it works it will work fairly quickly.

She doesn’t need inpatient. The Maudsley is a tertiary centre for the most severe. She does need an SSRI and some in person therapy.

You’ve avoided CAMHS because of the waiting list??? Do you not think you’d have moved up the waiting list in the meantime??
She needs medication (primarily) and therapy.

EMDR was what finally worked for me. Elements of OCD are still around and tend to surface if I'm really stressed but I know my triggers now and how to manage them.

Does she need to “work up” to trying an SSRI? I know DD would be worried about meds.

The Nightingale looks promising @Shrinkhole - do you have any experience of it? Or any other PPs?

@maybethisyear I have private medical care which I’ve used to get her therapy before - so I didn’t think it was necessary to go on the CAMHS list when I can get quick treatment via the private route. It’s just finding the right treatment. Unless going on the CAMHS list might give us access to treatment that private wouldn’t??

Isn’t EMDR more for if your issues are associated with trauma?

I’ve just noticed the Nightingale is for adults…

I am in same position looking for a good therapist. Am incredulous that people still think CAMHS is the way to go, particularly if you have private health care. My child was referred and turned away with a head tilt and warm words about how well he was doing - “didn’t meet threshold”. I am pleased it has worked for a PP but think this is a less common experience. Most people will see long waiting lists and a very, very high bar to acces help.

watching for recommendations. And sending sympathy OP, it is so hard.

I do know that experiences with Camhs are variable. Our experience is better than private though. We had previously tried priory.

Maudsley isn’t just inpatient focused. My DD’s treatment is overseen by Maudsley but delivered by local Camhs.

We didn’t wait for Camhs input though as my dd also had anorexia and was at a very low weight. We started intensive home treatment for that, and had to wait until she was weight restored to access therapy. The SSRI has made a huge difference to her and she will hopefully now be able to respond to therapy. She is ‘severe to extreme’ on the ratings scale though and isn’t able to attend an education setting etc.

Yes and no. It’s starting to be used more broadly. And trauma doesn’t have to be dramatic. There is evidence for EMDR in treating OCD but it isn’t as strong as the evidence for CBT/ERP.

The dose of SSRI for OCD is also quite a bit higher than for depression / anxiety.

We did actually have a crappy initial assessment with Camhs two years before she became really unwell. I think there are resource issues with Camhs and it often depends who you see.

But my experience is that it’s multidisciplinary, with inpatient back up, and our experience of Priory was not at all good. We went because we thought it would be better.

Part of the diagnosis of OCD is that people are distressed by their obsessions and compulsions. Not all obsessive and compulsive behaviours are OCD. There is a lot of effective treatment for people who have OCD and want to work on feeling less distressed and less functionally impaired.

OP - have a look at this clinic if you can afford private, I think one of their clinic areas is Herne Hill. https://www.integrativecentreforocd.co.uk/