This summer, Seattle Children’s launched a new OCD intensive outpatient program. It is one of a small number of intensive treatment programs in the country designed to treat children and adolescents who have already had a trial of therapy for OCD and still are largely symptomatic.
The program, which typically takes between four to eight weeks to complete, uses Exposure and Response Prevention (ERP), which is the evidence-based cognitive behavioral therapy for OCD. The patients and their parents or caregivers come to Seattle Children’s four days a week for three hours a day for the treatment.
Dr. Geoffrey Wiegand, director of the OCD Intensive Outpatient Program at Seattle Children’s, explains how the program is helping children with OCD lead better lives.
How does ERP therapy work?
It’s a way of helping kids learn to resist the urge to do the rituals and behaviors that OCD demands. We work with patients to conquer this by gradually exposing them to the thoughts, images, objects or situations that cause them anxiety and help them learn new ways of coping with their anxious feelings and also change the way they respond.
If you use a step-by-step approach to repeatedly expose people to the things that are frightening, while also providing support, eventually their fear resolves. Take, for instance, someone who is afraid of spiders. Over time we expose them to what they fear, first starting out with pictures of spiders then slowly helping them get closer and closer to a spider.
When should a provider refer their patient to the program? Are there specific eligibility requirements?
If the patient has had at least two months of OCD treatment in a weekly outpatient setting and is still struggling with significant OCD symptoms that interfere with school and/or social functioning or cause considerable distress, then they’re a good candidate.
Once a patient is referred, what is the process?
Parents can call into the Seattle Children’s general intake line, where they’ll get a phone triage and a recommendation for screening and evaluation appointments. These can be either two hour-long appointments or one two-hour appointment. We’ll confirm the diagnosis, check the patient’s history and administer the Children’s Yale-Brown Obsessive Compulsive Disorder Scale to determine the severity of their OCD. We’ll also check their insurance to see if they need a pre-authorization, and if they do, make sure we get it before we refer them to the program. It’s usually a process that takes about one to two weeks.
Is a provider referral required for patients who want to join the program?
Not necessarily, because we don’t want to put up barriers to care. We allow families to self-refer, but recommend they discuss the program with their outpatient provider prior to contacting us. We always welcome referrals from community partners, in fact, participation in the program requires the patient to have an ongoing provider to return to once they’ve completed our program.
What is the success rate so far?
Although our program is new, the results have been impressive and the initial outcomes are very promising. Our graduates, all of whom started with “extreme” or “severe” ratings on the scale for OCD, progressed to the “mild” or “sub-clinical” category by the end of the program and no longer meet the criteria for a diagnosis of OCD.
Is the program accepting new patients?
Yes. We accept new patients on a rolling basis. We keep enrollment low to assure a very high clinician to patient ratio so as to provide optimum support to each OCD IOP participant.
If you have a patient who needs intensive OCD treatment, contact Seattle Children’s Psychiatry and Behavioral Medicine Team at 206-987-2164.