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Choosing the right therapistIdeally your therapist should be: Someone you can trust or believe that you can come to trust Someone who can respect you, and you can respect in the same way Someone who is good at therapy and helping people to make changes Someone who knows how to avoid the most serious pitfalls (usually this means someone who is trained, preferably with experience in treating OCD) Someone who keeps up to date with new developments $#PP-Factors to consider when choosing a therapist..(Location Training Specialist vs. generalist Experience Gender (where it matters) Preferred style of working (length of sessions, number of sessions, frequency, in vivo work, set homework) Therapist ideas about how OCD can be treated / reasonable goals for treatment Do they set homework / go out during a session if necessary? Danger signs: Shifty / avoidant when asked questions Expert in everything The pessimistic therapist XVPWPPW%Questions to ask about your therapist*&(((What qualifications / experience do you have? Don t be impressed by titles Ask about specific experience with your problem & current caseload Ask about their supervision Trainees: not necessarily a problem Less likely to be dogmatic More likely to be  up to date More likely to be enthusiastic More likely to have supervision t.|%y.|%y  "Types of therapist (core training)Cognitive-behavioural nurse therapist Psychiatrist Clinical Psychologist MH Nurse Community Psychiatric Nurse Occupational Therapist Counsellor Counselling PsychologistZc1Getting the most out of your therapy: preparation22(Prepare a brief time line and history of your problem Be aware of things which you find difficult to discuss. Try to decide not to keep important secrets (once comfortable with your therapist). OCD likes secrets. Writing things down can help, either as notes for yourself or to hand to therapist Ask for reading Make sure you are on time & don t miss sessions $lPPn *Preparation cont.: Think about your goals++((Short term goals: goals which you can reasonably be achieved in 2-4 sessions Medium term goals: what can reasonably be achieved by the end of therapy Long terms goals: what you would like to do over the next few years, particularly emphasising positive changes and  growth targets -> Specific, Measurable, Achievable, Realistic, Testable Things to enjoy or look forward to, not just things to not do. L=9|Helping the right therapistMake sure you understand what the therapist is trying to help you to do & why Try to help motivate them: good attendance & homework go a long way Make sure that they keep on track, do the right work and set the right homework and work with you to make sense of it Try to keep the interval between your sessions as regular as possible  especially at times when you re struggling Sometimes you might want to help them involve others in your environment P"!Helping the right therapist cont.Remember: You know more about your problem than your therapist Therapists need your help but may not want to admit it Try to be active and collaborative Ask if the sessions can be audiotaped May have to do this yourself Good tape recorder, external microphone Listen to the tapes and make notes! Ask questions Don t shy away from try out new ways of doing thingst ZmZJZjZDZ mJjD $Better therapy?:Treat your therapist as a human being: remember they have faults and make mistakes too Be prepared to do most of the work yourself: therapist as a coach. 168 hours in a week If you have given it a chance and it s not working, be honest about this. It s not criticism, just a fact. Z~Unhelpful beliefsThis is my last chance to get better. This problem can only be managed: I m kidding myself if I think I can overcome it. A setback = failure = back to square one. My problem is unique. Having these thoughts makes me a bad person. Doing rituals & avoiding things is the only way out of this problem. I should keep secrets in therapy or not discuss some thoughts or my therapist will be shocked. A problem that s been around for this long will take even longer to treat.P!Some helpful ideaspNot every journey that starts with a single step has to take 1000 miles Aim to be as consistent as possible in doing this, rather than doing it as a quick test that you force yourself to do It s not just what you do, it s how you do it that s important: cheating just delays progress Your unlikely to get this right all the time & that s ok  people never progress in a perfectly straight line Setbacks are helpful provided you pick yourself up and keep going The intention in CBT (in the first instance) isn t to reduce anxiety or get rid of the thoughts  it s to find out whether what the OCD is telling you is true The Golden Rule: always do the opposite of what the problem tells you to do P/!  0` .T3f` T3f3f` 999MMM` lff3f3޲` eoHff33Ҷ` ff!>?" dd@,?nPd@  d " @ ` n?" dd@   @@``PR(   @ ` `Hp>> RJ ( )?  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