The Gateway Institute specializes in providing the most advanced treatment techniques to overcome OCD and anxiety disorders.
Cognitive Behavioral Therapy (CBT)
Cognitive Behavioral Therapy (CBT) is highly effective in treating anxiety disorders. CBT is an integration of two originally separate theoretical approaches to understand and treat psychological disorders; the behavioral approach, and the cognitive approach.
The cognitive approach focuses on the role of the mind, and specifically on cognitions. Patients with OCD and anxiety often suffer from overestimating the probability of danger as well as jumping to conclusions without evidence to support their thoughts. During treatment, sufferers are taught to identify and self-correct these misconceptions, and cognitive therapy helps restructure thinking patterns which support their fears. Cognitive therapy teaches you healthy and effective ways of responding to obsessive thoughts, without resorting to compulsive behavior.
Behavioral therapy helps people modify their reactions to anxiety-provoking situations. It is also used to educate individuals in methods of self control, and focuses on problems in the present rather than in the past. One type of behavioral therapy is Exposure Response Prevention, or ERP, which is explained below.
Recent studies have significantly advanced the understanding of how CBT affects the brain and its effectiveness in treating many disorders including anxiety, OCD, panic disorder, and post traumatic stress disorder to name a few. A patient receiving CBT administered in the traditional manner of treatment one time per week can expect to see clinical improvements in up to 12 weeks. However, in a study conducted at the University of California, Los Angeles, it was discovered that significant changes in brain activity were realized after just three to four weeks of CBT in a more intensive daily treatment program treating OCD. These OCD patients showed significant improvements in their symptoms, depression, anxiety and overall functioning. Each person who enrolls at the Gateway Institute will be evaluated based on the symptoms that they present, and the best course of treatment will be established to ensure they get the most results from the program.
Exposure Response Prevention (ERP)
The most widely practiced behavioral therapy for OCD is called Exposure and Response Prevention (ERP). Exposure treatment involves direct (in-vivo) or imagined exposure to objects or situations that trigger obsessions that arouses one’s anxiety. Over time, exposure to these cues leads to decreased anxiety until eventually, exposure arouses little or no anxiety at all. This process is called habituation. Studies show that exposure and response prevention can in fact train your brain, significantly reducing the occurrence of OCD symptoms.
The response component of ERP refers to the act of engaging in ritualistic behaviors in an effort to reduce the anxiety caused by OCD. In ERP treatment, patients learn to resist and prevent themselves from acting on their compulsions, and desire to perform rituals. With successful ERP, the sufferer eventually stops engaging in their ritualistic and obsessive behaviors. ERP helps break the link between your obsessive thoughts and compulsive rituals that will allow you to manage your OCD without the OCD managing you.
Exposure Therapy (ET)
Exposure Therapy (ET) is a form of behavioral therapy that provides the most effective treatment for individuals suffering from anxiety disorders. Exposure therapy can be utilized with general anxiety, social anxiety, post traumatic stress disorder, obsessive compulsive disorder, acute stress, panic attacks or other trauma-related issues and phobias. People that suffer from anxiety recognize that their fears are irrational and exaggerated but are unable to control their fight or flight system and therefore, end up experiencing continuous anxiety. This form of therapy has been scientifically proven to retrain the brain to no longer fear perceived thoughts, objects, people or experiences that used to trigger the sufferer. With Exposure Therapy, clients are able to face and overcome fearful past triggers and relieve anxiety.
Types of Exposures:
- In-Vivo or Live Exposures- These are real life experiences that provide the sufferer with a live experience of confronting that which they fear. Through clinical support and coaching from the therapists, clients are able to engage in a fear or situation while learning the skills and tools to overcome the trigger.
- Imaginary Exposures- These exposures are done through writing and reading techniques. This is usually used when In-Vivo exposures cannot be performed.
With exposure therapy, those suffering from anxiety will be able to “habituate” to the fearful trigger, situation or person, which results in decreased anxiety and increased mental health and happiness.
Mindfulness Based Behavioral Therapy (MBBT)
Using the advances made in the treatment of OCD over the past 10 years, The Gateway Institute incorporates the most current techniques in its treatment programs. Some of these advanced treatments include Mindfulness Based Behavioral Therapy (MBBT). In our practice, we have discovered that a comprehensive treatment strategy that we refer to as Mindfulness Based Behavioral Therapy improves treatment response. In MBBT we incorporate informal mindfulness training along with exposure and response prevention (ERP), and a writing intervention with both behavioral and mindfulness components that contribute to treatment effectiveness.
The focal point of MBBT is to increase one’s awareness of the present as well as recognizing OCD for what it is. Dr. Jeffrey Schwartz, author of Brain Lock, talks about the importance of this approach by taking various steps which include relabeling the OCD such as “It’s not me, it’s my OCD,” and secondly, reattributing OCD to a chemical imbalance in the brain which it is. Dr. Schwartz reminds us that those who suffer from OCD have the capacity to turn the tables on the OCD, and The Gateway Institute will help you do that.
Behavioral Therapy Combined With Medication
Though behavioral therapy may be the most effective treatment in terms of long term management of OCD, research indicates that combining both CBT and medication may be beneficial for overall success. Medications considered for the treatment of OCD are usually antidepressants know as selective serotonin reuptake inhibitors (SSRI), which are often effective without severe side effects. The Gateway Institute works with skilled and experienced psychiatrists to find the right combination of medication to effectively treat OCD when necessary.
A 90 minute weekly group will be held on Tuesday and Wednesday evenings, and the group’s specific focus involves providing members with support, guidance, and treatment related to their own progress. The group incorporates Cognitive-Behavioral therapy (CBT), and each week home-based challenges are assigned. The group is a great opportunity to establish relations with others who can appreciate the daily challenges of this potentially disabling condition. Sign up for the OCD/Anxiety Support Group.
After-Care is an important component to our treatment program. Learning how to manage the OCD will involve a lifestyle change. Since OCD is a chronic condition, a commitment to working diligently on a daily basis while transitioning back into daily life will be necessary. The After-Care program equips the participant with the necessary tools for success, and promotes long-lasting change. Once the symptoms of OCD have improved, a number of strategies can help maintain the gains made, and The Gateway Institute will help devise a plan to help find the road to successfully managing OCD.
For clients with particular subtypes of OCD such as hoarding or contaminating, home-visits may be available to conduct exposure exercises. This allows the therapist to help guide the clients through challenging home-based exercises. Ultimately, these exercises conducted in the presence of the therapist, will be performed independently by the client.