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Module 2 Video Reflection article

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Module 2 Video Reflection article

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Module 2 Graphic retrieved from https://www.psychologytoday.com/us/blog/theory-knowledge/201811/the-college-student-mental-health-crisis-update

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Module 3 Presentation article

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NEDA Educator Toolkit - Eating Disorders

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NEDA Educator Toolkit - Eating Disorders

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Module 3 Presentation article

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Eating Disorder Statistics - Men & Women

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Eating Disorder Statistics - Men & Women

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Retrieved from https://www.thelantern.com/2014/02/support-available-ohio-state-students-eating-disorders/

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Module 4 Handout Resource

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National Eating Disorders Association - Warning Signs & Symptoms

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National Eating Disorders Association - Warning Signs & Symptoms

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Module 3 Presentation website

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Module 3 Presentation Resource

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Shades Of Hope is a residential and extended care all-addictions treatment center specializing in the treatment of eating disorders , including anorexia, bulimia, food addiction, binge eating and compulsive overeating, as well as co-occurring addictions, such as alcohol and drug addiction .

Using the time-tested 12-step program, a full staff of medical and clinical professionals is dedicated to helping clients break the cycle of addiction and disordered eating, retain positive changes and live the healthy, successful lives they deserve. We're proud to serve the greater Buffalo Gap & Abilene, TX areas. today to discuss your situation.

Please also visit Hope of Shades Foundation here:

2019 Intensive Dates

Aug. 12-16, Sept. 9-13, Oct. 7-11, Nov. 11-15, Dec. 9-13

Weekly & Monthly Treatment Options Available

At Shades Of Hope, there's a light at the end of the tunnel. No matter what addictions you struggle with, even if it's several, help and support are available. We have different programs available that are specifically geared toward different addictions.

We believe that addiction can be overcome. You'll learn the tools with which to do so at Shades Of Hope. If you truly want to change and are willing to put in the amount of work required to do so, Shades Of Hope is the place for you. today to get started.

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Addiction Treatment | Buffalo Gap & Abilene, TX | Shades Of Hope

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Shades Of Hope is a residential and extended care all-addictions treatment center specializing in the treatment of eating disorders , including anorexia, bulimia, food addiction, binge eating and compulsive overeating, as well as co-occurring addictions, such as alcohol and drug addiction .

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Module 3 Presentation picture retrieved from https://www.infobae.com/tendencias/2017/10/09/bulimia-y-anorexia-como-fue-su-evolucion-en-la-historia/

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Signs a College Student May Have an Eating Disorder - Child Mind Institute

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Signs a College Student May Have an Eating Disorder - Child Mind Institute

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Module 3 Presentation website

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The first warning signs that your college-age child, or your friend in college, may have an eating disorder is often not what she does but what she says.

Try tuning in to how she talks (and how much she talks) about herself.

"I'm so fat. I'm a pig."

"I wish I looked like her."

"I'm on a diet."

Of course not everyone who wishes she was thinner or looked a bit more like a supermodel has an eating disorder, but this kind of self-loathing language can be a warning flag. When someone begins to show constant preoccupation with thinness, diet, or body image it might be time to listen a little more closely.

Hating her body

"I couldn't stop comparing myself to every girl I saw," says Jessica, who struggled with anorexia during her late teens and early twenties. " 'Am I thinner than her? Am I fatter?' It was endless, and I was almost always the fat one. It was all I thought about so it was all I wanted to talk about."

This kind of constant self-criticism is pretty common, and can be a clue to friends, parents, and clinicians that an eating disorder may be developing.

"Eating disorders are not about vanity or just the desire to be thin," explains Dr. Alison Baker, "but it's important not to dismiss that piece of it because it can be the language of distress. In a lot of cases this is the first clue. People express their anxieties and complaints by wishing they looked more like someone in their community or a movie star."

College is a place where you can find people to participate in almost anything you're interested in, and criticizing your body is no exception. Now 25 and in recovery, Jessica says it was easy to get other girls talking about how much they hated their bodies-even if they didn't have an eating disorder. "We were all worried about our weight. Someone was always willing to go down the rabbit hole with me," she says.

Related: Eating Disorders and College

Weighty worries

While some weight concerns are normal, the mix of anxiety and the constant pressure to be thin can be a very dangerous mix for some. A history of serious anxiety is a strong indicator for eating disorders during college.

Dr. Baker, a child and adolescent psychiatrist, notes that if a student seems very stressed out, or down, and has been obsessing over losing weight, it's important to intervene.

"If she's reporting that she's unhappy or very anxious, and she looks very different than the last time you saw her, then it's time to ask," says Dr. Baker. Eating disorders include anorexia, bulimia, and binge eating disorder, and each disorder has a different set of signs.

Anorexia

Anorexia is characterized by an intense fear of gaining weight. People with anorexia go to extremes, restricting food and over-exercising to prevent weight gain.

Signs that someone might be anorexic include:

Obsession with getting thinner: Constant preoccupation with gaining weight, calories, food intake, or food ingredients that might be "fattening." A general obsession with body size and weight.

Excessive exercising: This goes way beyond being a gym rat. If someone spends hours running on the treadmill to "work off" a small snack, or insists on going jogging outside even when she's sick or the weather's bad, that may be cause for concern.

Food avoidance, hiding and lying: People with eating disorders often try to hide what's happening from friends and family, which can make it harder to spot a problem. This might mean:

Skipping meals, or parties where eating or drinking are the main event.

Avoiding the dining hall

Always saying she's had a big breakfast or is in "too much of a hurry" to eat.

Wearing baggy clothes to hide weight loss.

A need for control: People at risk for anorexia are perfectionists and often set impossible goals for themselves, whether it's getting straight A's, having a super-clean room, or being the president of every club on campus. When the chaos of college makes it hard to control their environment, people with anorexia try to alleviate stress and anxiety by controlling the one thing they feel in charge of-their bodies.

Serious weight loss: Losing a ton of weight, especially in a short period of time, is a sign of real danger. If someone looks painfully thin it's time to seek help.

Bulimia

Like anorexia, bulimia is a serious eating disorder characterized by an overpowering obsession with body image and desire to lose weight. However, it takes a very different form when it comes to signs and symptoms.

Bulimia is a cycle of binging-eating large amounts of food in a short period of time-and purging, which could include self-inducing vomiting, abusing laxatives or diuretics, over-exercising, or a combination of all three. People with bulimia aren't necessarily noticeably thin, which can make it harder to spot.

Signs someone might be bulimic include:
Binging and purging:

Buying and hiding large amounts of food

Hiding uneaten food or wrappers from binges

Inventing reasons to go to the bathroom to purge-if someone is always disappearing after a meal, that's a big tip-off.

Bad breath, swelling under the jaw or cheeks, tooth discoloration, acid reflux, or even knuckle calluses from self-induced vomiting.

Obsessing about weight: Talking about weight and size more than is usually considered normal. Constantly comparing her body to the bodies of friends, strangers, and movie stars-and always finding herself wanting.
Withdrawal from social events:

Skipping parties where eating is important

No longer engaging in things she used to enjoy.

Passing on activities that interfere with the routine of binging and purging.

Binge eating disorder

People who struggle with binge eating disorder (BED) will frequently eat large amounts of food, but unlike a person with bulimia, they don't engage in any of the "purging" behaviors. The disorder is different from anorexia and bulimia because people with BED are not preoccupied with thinness, although they may struggle with poor self-esteem and often feel guilty and ashamed over any weight they've gained from their binges.

People with binge eating disorder may be feeling overwhelmed or out of control-they may struggle with managing stress or difficult emotions-and use food as a way to comfort themselves. Binge eating disorder is often associated with depression.

Signs that someone may have BED include:

Rapid weight gain: Binge eating leads to weight gain and can cause serious health problems including heart disease, diabetes, high blood pressure, and others. Kids who are binge eating may be wearing really baggy clothes to hide weight gain.

Hiding out: For people with BED, binging is usually done in private. If someone is making excuses to eat alone, hiding food around her room, or you've notice large amounts of food missing from the dorm, it might be a sign of trouble.

Depression and withdrawal: People with BED often struggle with feelings of guilt and shame after a binge, becoming depressed and isolated which perpetuates the binge-eating cycle.

Related: Helping College Kids With Depression

Eating disorders don't discriminate
Recognizing an eating disorder sometimes means looking beyond the typical stereotype.

Eating disorders are more prevalent in females, but approximately 10% of people with anorexia and 40% of those with binge eating disorder are male. Boys and men with an eating disorder often go overlooked. If the signs are there, don't discount the possibility of an eating disorder because someone doesn't fit the stereotype.

Read More:
How to Help Someone With an Eating Disorder in College

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Signs a College Student May Have an Eating Disorder

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The first warning signs that your college-age child, or your friend in college, may have an eating disorder is often not what she does but what she says. Try tuning in to how she talks (and how much she talks) about herself. "I'm so fat. I'm a pig."

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Counseling Youth Who Have Bipolar Disorder

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Counseling Youth Who Have Bipolar Disorder

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Module 4 Handout article

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Our Mission

As a nationally recognized provider of behavioral health services to older adults and seniors, we are committed to caring for this special population with dignity for patients and their families; with keen awareness of the importance of treating the whole person; with focus on progressive behavioral therapies; and with respect for our employees, physicians, healthcare providers and the communities we serve.

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As a nationally recognized provider of behavioral health services to older adults and seniors, we are committed to caring for this special population with dignity for patients and their families; with keen awareness of the importance of treating the whole person; with focus on progressive behavioral therapies; and with respect for our employees, physicians, healthcare providers and the communities we serve.

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National Alliance on Mental Illness Abilene

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National Alliance on Mental Illness Abilene

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Module 4 Handout Resource

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NAMI Abilene is a newly formed Affiliate of NAMI Texas. Reaching Affiliate status in March 2017, NAMI Abilene holds general meetings on the First Tuesdays of the month at 6 p.m. at the Grace Fellowship Church, 910 Cypress Street, Abilene. These meetings are open to the community and will feature informative speakers. NAMI Abilene will participate in area mental health and behavioral events; hold education and support groups; train volunteers to lead groups and classes; and become informed on mental health advocacy issues. The Affiliate's service area includes Taylor and Jones counties.
Mission & Vision Statements
NAMI Abilene seeks to improve the lives of those affected by mental illness by providing support, education, and advocacy to individuals and their families in Northwest Texas.

NAMI Abilene focuses on the belief that people with mental illness can lead meaningful, productive lives. We endeavor to promote a greater understanding about these illnesses-including those with a dual diagnosis, facilitate access to treatment and related services, and keep hope alive for people with mental illness and their loved ones. We further seek to eliminate stigma. We don't see the illness; we see the person.
Programs

NAMI Connection Peer Support Group - a free, ongoing support group for people living with mental illness

NAMI Family Support Group - a free support group for families of individuals living with mental illness

NAMI In Our Own Voice - a free presentation that unmasks mental illness using speaker stories to illustrate the realities of living with a mental illness and staying in recovery; NAMI In Our Own Voice can change attitudes, preconceived notions, and stereotypes regarding mental illness

NAMI Peer-to-Peer - a free, 10-session educational program for adults with mental illness who are looking to better understand their condition and journey toward recovery

NAMI Night Big Country - a monthly, free education meeting open to the general public featuring a guest speaker focusing on mental health and/or substance abuse recovery; snacks provided

All meetings are held at Grace Fellowship Church, 901 Cypress Street, Abilene, TX.
Upcoming Events Past Events
Click the image below to view the PDF!

NAMI Nights Big Country Flyer
Become a Member
Annual Dues are $60 per household, $40 per individual, and $5 for those with limited finances.

Please make checks payable to "NAMI Texas" and make a notation on the bottom of the check for: "NAMI Abilene". Then, mail membership form and payment to NAMI Texas, P.O. Box 300817, Austin, TX 78703.

Credit cards may be used electronically at the following link:
Volunteer Opportunities
NAMI Abilene needs YOU!

NAMI's mission has been shaped and supported by its grassroots volunteers since the beginning. NAMI volunteers are crucial to the success of our NAMI Abilene Affiliate.

NAMI Abilene Volunteer Opportunities: We still have openings on several of our committees, including Finance, Communications, Membership, Programs, and Advocacy. Please call Byl (Bill) at (325) 627-8781 or write williamboyd@namiabilene.org.

NAMI Program Training Opportunities: Help decrease stigma and raise awareness with these important programs!

NAMI Connection Support Group Leader Training for those in recovery: To register, call Byl at (325) 627-8781.

NAMI Family Support Group Facilitator Training for family members: To register, call Byl at (325) 627-8781.

NAMI In Our Own Voice To schedule a presentation for your group, church, or organization, call us at (325) 627-8781.

NAMI Peer-to-Peer Classes forming now for adults. Register by calling (325) 627-8781.

PHOENIX Clubhouse - A Clubhouse is a social community rehabilitation model for persons recovering from mental illness. The Clubhouse is a wellness model designed to create an environment that requires the volunteerism of its members to work side by side with staff in the running of every part of the Clubhouse.

Newsletters
Click on the image below to view our latest newsletter!

Inaugural Issue - January 2017
Spring 2017 Newsletter Issue
Summer 2017 Newsletter Issue
Special Conference Issue - Fall 2017
Fall 2017 Newsletter Issue
Winter 2018 Newsletter Issue
Spring 2018 Newsletter Issue
Summer 2018 Newsletter Issue
Special Conference Issue- Fall 2018
Special Events PHOENIX Celebration Flyer Contact NAMI Abilene Abilene Gives 2018
Social Media
NAMI Fest 2017 Flyer
williamboyd@namiabilene.org
(325) 627-8781
Donate Now Make a donation to NAMI Abilene
Facebook
www.facebook.com/namiabilene.org

Twitter
@nami_abilene

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NAMI Abilene is a newly formed Affiliate of NAMI Texas. Reaching Affiliate status in March 2017, NAMI Abilene holds general meetings on the First Tuesdays of the month at 6 p.m. at the Grace Fellowship Church, 910 Cypress Street, Abilene. These meetings are open to the community and will feature informative speakers.

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Module 4 Handout Resource

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eLearning Hub

This resource center is designed to equip you with knowledge, resources, and a sense of hope for the future - for yourself or someone else you care about.

Check out our eLearning Hub to learn more about common behavioral health conditions.

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Find Resources or a Provider | You're Not Alone | Mental Health Texas

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Mental Health Texas provides learning and treatment opportunities for those coping with mental health conditions and those who support them.

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Module 4 Handout Resource

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The National Institute of Mental Health (NIMH) is the lead federal agency for research on mental disorders

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Individuals with Disabilities Education Act

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The Individuals with Disabilities Education Act (IDEA) is a law that makes available a free appropriate public education to eligible children with disabilities throughout the nation and ensures special education and related services to those children.

The IDEA governs how states and public agencies provide early intervention, special education, and related services to more than 8 million (as of school year 2022-23) eligible infants, toddlers, children, and youth with disabilities.

Infants and toddlers, birth through age 2, with disabilities and their families receive early intervention services under IDEA Part C. Children and youth ages 3 through 21 receive special education and related services under IDEA Part B.

Additionally, the IDEA authorizes:

Formula grants to states to support special education and related services and early intervention services.

Discretionary grants to state educational agencies, institutions of higher education, and other nonprofit organizations to support research, demonstrations, technical assistance and dissemination, technology development, personnel preparation and development, and parent-training and -information centers.

Congress reauthorized the IDEA in 2004 and most recently amended the IDEA through Public Law 114-95, the Every Student Succeeds Act, in December 2015.

In the law, Congress states:

Disability is a natural part of the human experience and in no way diminishes the right of individuals to participate in or contribute to society. Improving educational results for children with disabilities is an essential element of our national policy of ensuring equality of opportunity, full participation, independent living, and economic self-sufficiency for individuals with disabilities.

Other Laws for Children with Disabilities

The U.S. Department of Education's Office for Civil Rights (OCR) provides additional resources of interest for individuals with disabilities and their families.

OCR does not enforce the IDEA; however, OCR does enforce the Rehabilitation Act of 1973, Section 504 and Americans with Disabilities Act of 1990, Title II rights of IDEA-eligible students with disabilities.

To learn more, visit the OCR's Frequently Asked Questions About Section 504 and the Education of Children with Disabilities.

Visit OCR's website for additional resources.

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About IDEA - Individuals with Disabilities Education Act

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The IDEA is a law that makes available a free appropriate public education to eligible children with disabilities throughout the nation and ensures special education and related services to those children.

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Students with ODD Participating in Recess

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Students with ODD Participating in Recess

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Module 5 article

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Module 5 - retrieved from http://www.acupunctureessex.co.uk/blog/2018-01-19-taiji-qigong-shabashi-18-posture-tai-chi-chi-kung

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Oppositional Defiant Disorder: An Overview and Strategies for Educators

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Oppositional Defiant Disorder: An Overview and Strategies for Educators

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Effect of Art Therapy in Reducing ODD Symptoms

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Effect of Art Therapy in Reducing ODD Symptoms

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Anatomy or system affected: Psychic-emotional system

Definition: A disorder characterized by intrusive and unwanted but uncontrollable thoughts (obsessions) that lead to repeated behaviors (compulsions); the obsessions and/or compulsions cause severe stress, consume an excessive amount of time, and greatly interfere with a person's normal routine, activities, or relationships.

Causes: Psychological factors; may involve genetic, cognitive, and/or neurobiological factors

Symptoms: Repetitive behaviors, anxiety, persistent intrusive and uncontrollable thoughts, irrational fears

Duration: Often chronic with acute episodes

Treatments: Psychotherapy, drug therapy
Causes and Symptoms
Obsessive-compulsive disorder (OCD) is a disorder characterized by persistent intrusive and uncontrollable thoughts and the subsequent need to perform specific behaviors repeatedly. The presence of obsessions or compulsions must be time-consuming, cause distress or impairment, and be recognized as excessive or unreasonable by the person with OCD. The obsessions and compulsions must not be caused by medication, drug abuse, or another medical condition. Obsessive-compulsive behavior is highly distressing because it feels as if one's behavior or thoughts are no longer voluntarily controlled. The more frequently these uncontrolled alien and perhaps unacceptable thoughts or actions are performed, the more distress is induced. An individual with OCD may at various times have either obsessions (which are thought-related) or compulsions (which are action-related), or both.

OCD affects 1 to 2.5 percent of the population. Onset is bimodal and typically occurs before the age of thirty; most of those afflicted begin suffering from the disorder in late childhood (mean age ten years) or early adulthood (mean age twenty-one years). Onset is often preceded by a stressful event such as pregnancy, childbirth, or family conflict. It may be closely associated with mood disorders such as depression or anxiety, with OCD developing soon after a mood disorder or the mood disorder developing as a result of the OCD. OCD affects men and women in roughly equal numbers.

Individuals with OCD generally recognize and are distressed by the irrational or excessive nature of their obsessions and compulsions. However, the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) outlines specifiers for OCD related to the individual's degree of insight about the nature of their obsessions and compulsions, including good or fair insight, poor insight, and absent insight/delusional, which involves an absolute conviction that the OCD beliefs are valid and true. Obsessions generally fall into one of five recognized categories. Obsessive doubts are persistent doubts that a task has been completed; the individual is unwilling to accept and believe that the work is done satisfactorily. Obsessive thinking is an almost infinite chain of thought, targeting future events. Obsessive impulses are very strong urges to perform certain actions, whether they are trivial or serious, that would likely be harmful to the affected person or someone else or that are socially unacceptable. Obsessive fears are thoughts that the person has lost control and will act in some way that will cause public embarrassment. Obsessive images are continued visual pictures of either a real or an imagined event. Common obsessions relate to contamination, safety, the fear of committing a socially unacceptable behavior, the need for order, and sexual or aggressive thoughts.

Four factors are commonly associated with obsessive characteristics, not only in people with OCD but in the general population as well. First, obsessive individuals are unable to control their mental processes completely. Practically, this means the loss of control over thinking processes, such as intrusive thoughts of a loved one dying or worries about hurting someone unintentionally. Second, there may be thoughts and worries over the potential loss of motor control, perhaps causing impulses such as shouting obscenities in public or performing inappropriate sexual acts. Third, many obsessive individuals may be afraid of contamination and suffer irrational fear and worry over exposure to germs, dirt, or diseases. The last factor is checking behavior, or backtracking previous actions to ensure that the behavior was done properly, such as checking that doors and windows are shut, faucets are turned off, and so on.

Compulsions may be either mild or severe and debilitating. Mild compulsions might be superstitions, such as refusing to walk under a ladder, knocking on wood, or throwing salt over one's shoulder. Severe compulsions become fixed, unvaried ritualized behaviors; if these compulsions are not practiced precisely in a particular manner or a prescribed number of times, then intense anxiety may result. These strange behaviors may be rooted in superstition; many of those suffering from the disorder believe that performing the behavior may ward off danger. Compulsive acts are not ends in themselves but are "necessary" to produce or prevent a future event from occurring. Although the enactment of the ritual may assuage tension, the act does not give the person with OCD pleasure.

Common compulsions include cleaning, checking, counting, arranging, touching objects, hoarding, seeking reassurance, and making lists. For people with repeating compulsions, they must do everything by numbers. Checking is another compulsive act; a compulsive checker believes that it is necessary to check and recheck that everything is in order. Cleaning is a behavior in which the person believes he or she must engage; they may wash and scrub repeatedly, especially if they think that they have touched something dirty. A fourth common compulsive action is avoidance; for certain superstitious or magical reasons, certain objects must be avoided. Some individuals with compulsions experience compelling urges for perfection in even the most trivial of tasks; often the task is repeated to ensure that it has been done correctly. Some determine that objects must be in a particular arrangement; these individuals are considered "meticulous." A few people with OCD have hoarding compulsions; they are unable to throw away trash or rubbish. Many individuals have a constant need for reassurance; for example, they want to be told repeatedly that they have not been contaminated.
Treatment and Therapy
The direct cause of OCD is uncertain, and no single cause for OCD has been isolated. Sigmund Freud (1856-1939) first proposed that obsessive thoughts are a replacement for more disturbing thoughts or actions that induce guilt or anxiety in the sufferer. However, this view has been discredited, and today it is believed that OCD is caused by a complex interaction of genetic, behavioral, cognitive, cultural, and neurobiological factors. OCD tends to run in families; however, genes appear to be only partly responsible for causing OCD. Twin studies have suggested that genetic factors influence 45 to 65 percent of cases of childhood-onset OCD and 27 to 47 percent of adult-onset OCD. Other suspected influences include abnormalities with the neurotransmitter serotonin in the brain.

Diagnostic techniques evaluating OCD usually involve psychological evaluation. It is important to determine whether an individual is actually suffering from OCD or other potential problems such as schizophrenia or a mood disorder. Additionally, it is important to determine whether more than one disorder is present. OCD may occur in conjunction with other disorders, such as substance use disorders, eating disorders, and mood disorders. When this occurs, treatment must be adjusted. For example, when depression is also noted, both disorders must be addressed in treatment. OCD is related to other disorders characterized by repetitive behaviors and intrusive thoughts, including body dysmorphic disorder, hoarding disorder, trichotillomania, and excoriation disorder.

In cases when differentiation is required between OCD and schizophrenia, the concern is to understand the nature of the dysfunctional thoughts and behaviors. For instance, a distinction can be made by determining the motive behind the ritualized behavior. Stereotyped behaviors are symptomatic of both disorders. In the person with schizophrenia, however, the behavior is triggered by delusions rather than by compulsions. People suffering from delusions do not resist the ideas inundating their minds, and ritualized behavior does not necessarily decrease the feelings associated with the intrusive ideas. On the other hand, people with OCD usually experience decreases in anxiety when they perform their rituals and may be absolutely certain of the need to perform their rituals, though other aspects of their thinking and logic are perfectly clear. They generally resist the ideas that enter their minds and realize the absurdity or abnormality of the thoughts to some extent. As thoughts and images intrude into the mind, the person may sometimes appear to have symptoms that mimic schizophrenia.

Other problems having symptoms in common with OCD are stimulant abuse, Tourette syndrome, and other tic disorders. What seems to separate the symptoms of these disorders from those experienced with OCD is that the former are organically induced. Thus, the actions of a sufferer from Tourette syndrome may be mechanical since they are not purposely enacted. In the case of the stimulant user, the acts may bring pleasure and are not resisted, but reinforced by the drug effects.

Most people experience obsessive thoughts on occasion; in fact, the obsessions of individuals without OCD are not significantly different from the obsessions of those with OCD. The major difference is that those with the disorder have longer-lasting, more intense, and less easily dismissed obsessive thoughts. The importance of this overlap is that mere symptoms are not a reliable tool to diagnose OCD, since some of the same symptoms are experienced by the general population.

Assessment of OCD separates the obsessive from the compulsive components so that each can be examined. Obsession assessment should determine the triggering fears of the disorder, both internal and external, including thoughts of unpleasant consequences. The amount of anxiety that these obsessions produce should be monitored. The compulsive behaviors then should be examined in the same light. DSM-5 criteria include the presence of time-consuming (more than one hour per day) obsessions and compulsions that cause significant distress; that interfere with or reduce the quality of the individual's social, academic, or occupational functioning; and that are not better explained by another mental disorder or substance use.

The greatest chance for successful treatment occurs with individuals who experience mild symptoms who seek help soon after the onset of symptoms and who had few problems before the disorder began. Many valuable and successful treatment strategies are available for OCD. The American Psychiatric Association and the US National Institute for Health and Care Excellence (NICE) recommend exposure-and-response-prevention, a form of cognitive-behavioral therapy (CBT), and/or selective serotonin reuptake inhibitors (SSRIs) as first-line treatments, depending on the patient's preference, the level of OCD complexity and severity, and the presence of depressive symptoms. The NICE recommends low-intensity CBT alone for mild cases of OCD.

The most effective treatment for controlling OCD is the behavioral therapy. CBT involves the identification of misperceptions and negative thoughts and repeated attempts to challenge these beliefs and replace them with less distressing thoughts. CBT may include psychoeducation, cognitive training, mapping OCD target symptoms, and exposure-and-response-prevention therapy. Exposure-and-response-prevention therapy (also called exposure-and-ritual-prevention therapy) is a form of CBT specifically designed to treat OCD symptoms. It involves gradual yet prolonged confrontation with the anxiety-producing stimuli in the presence of a supportive therapy. This exposure often begins with imagined stimuli or photographs and eventually progresses to real-life exposure to the anxiety-provoking stimuli. The exposure continues until the person's anxiety decreases, in a process called habituation. Exposure-and-response-prevention therapy also involves active abstinence from rituals and compulsive behaviors, although this approach does not involve active blocking of the person's compulsions. Exposure-and-response-prevention therapy is highly effective in the treatment of OCD, particularly when the client has less severe forms of OCD, does not have a comorbid diagnosis of depression, adheres to exposure homework early in the therapeutic process, has contamination fears or overt ritualistic behaviors, and has undergone no previous treatment.

Therapeutic approaches to the treatment of OCD may be supplemented with medications. Selective serotonin reuptake inhibitors (SSRIs) are considered to be the first-line agents for the treatment of OCD and often have remarkable effects on OCD, helping individuals to experience a change in their thinking and behavior, as well as providing relief. SSRIs appear to improve OCD symptoms compared with tricyclic antidepressants or monoamine oxidase inhibitors. Approximately 40 to 60 percent of persons with OCD will respond to SSRIs.
Perspective and Prospects
Some psychiatrists may recommend neurosurgery to relieve a patient's symptoms in very severe or intractable cases. Cingulotomy and deep brain stimulation are reported to reduce symptom severity in patients with treatment-refractory OCD. Electroconvulsive therapy has also been reported to be effective in the treatment of OCD in case reports; however, no high-quality, placebo-controlled trials have studied the efficacy of this treatment. Alternative treatments for OCD that have demonstrated benefit include kundalini yoga, mindfulness meditation, and progressive muscle relaxation.

Descriptions of OCD-like behavior go back to medieval times; a young man who could not control his urge to stick out his tongue or blurt out obscenities during prayer was reported in the fifteenth century. Medical accounts of the disorder and the term "obsessive-compulsive" originated in the mid-nineteenth century. At that time, obsessions were believed to occur when mental energy ran low. Later, Freud attributed the characteristics to a regression to early childhood, when there are perhaps strong urges to be violent and/or to dirty and mess one's surroundings. To avoid acting on these tendencies, he theorized, an avoidance mechanism is employed, and the symptoms of obsession and/or compulsion appear.
Bibliography
Although not totally disabling, OCD behaviors can be strongly incapacitating and cause a significant amount of distress. Most parents will agree that children commonly have rituals to which they must adhere or compulsive actions they carry out. A particular bedtime story may be read every night for months on end, and children's games involve counting or checking rituals. It is also not atypical for adults without psychiatric disorders to experience some mild obsessive thoughts or compulsive actions, as seen in an overly tidy person or in group rituals performed in some religious sects. Excessively stressful events may trigger obsessions as well. Further research into the biopsychosocial causes of OCD will be important in developing future treatment approaches.

American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders: DSM-5. 5th ed. Arlington: American Psychiatric Assoc., 2013. Print.

Barlow, David H. Anxiety and Its Disorders. 2nd ed. New York: Guilford, 2004. Print.

Barlow, David H., ed. Clinical Handbook of Psychological Disorders. 4th ed. New York: Guilford, 2008. Print.

Crowe, Elijah M., and Aiden R. O'Dell, eds. Obsessive-Compulsive Disorder: Symptoms, Prevalence, and Psychological Treatments. New York: Nova, 2014. Print.

Durand, V. Mark, and David H. Barlow. Essentials of Abnormal Psychology. 7th ed. Boston: Cengage Learning, 2016. Print.

Grant, Jon E., Samuel R. Chamberlain, and Brian L. Odlaug. Clinical Guide to Obsessive Compulsive and Related Disorders. Oxford: Oxford UP, 2014. Print.

Kring, Ann M., et al. Abnormal Psychology. 12th ed. Hoboken: Wiley, 2012. Print.

Menzies, Ross, and Padmal de Silva, eds. Obsessive Compulsive Disorder: Theory, Research, and Treatment. New York: Wiley, 2003. Print.

Oltmanns, Thomas F., et al. Case Studies in Abnormal Psychology. 9th ed. Hoboken: Wiley, 2012. Print.

Copyright of Magill's Medical Guide (Online Edition) is the property of Salem Press. The copyright in an individual article may be maintained by the author in certain cases. Content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use.
Source: Magill's Medical Guide (Online Edition), 4p
Item: 86194355

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Anatomy or system affected: Psychic-emotional system Definition: A disorder characterized by intrusive and unwanted but uncontrollable thoughts (obsessions) that lead to repeated behaviors (compulsions); the obsessions and/or compulsions cause severe stress, consume an excessive amount of time, and greatly interfere with a person's normal routine, activities, or relationships.

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Most children and parents will have some distress or upset - so how do I know when a child or family needs additional help?

Ask your patients (and their parents) about reactions and coping.

Listen for ongoing or severe traumatic stress symptoms.

Consider a referral for a more thorough evaluation with a mental health professional if:

Traumatic stress reactions are severe or prolonged (more than a month).

Traumatic stress reactions interfere with recovery or with returning to normal activities.

Consider: Is the child participating in daily activities to the extent possible given their medical condition? Are stress reactions interfering with treatment adherence? Are new fears or worries troubling the child or parent?

Steps for making a referral Effective mental health treatment for traumatic stress Online resources - help in finding a mental health professional Distinguishing between types of mental health professionals
Therapist Resource Guide: There are many ongoing stressors that children and families endure after diagnosis of an illness or an injury. This guide focuses specifically on medical traumatic stress and responses that children and families may have.

Steps for making a referral

Mention concerns you have identified.
Say something like: "I'm concerned that (you are / your child is) having these upsetting thoughts and feelings. It might be useful to talk with a specialist who can help your family more."

Involve child and family in making a plan.
Ask for their ideas about what is needed now
Say something like: "What issues or difficulties are impacting you / your family the most right now? What would help make things better?"

Ask for permission to offer advice. Present advice as range of possibilities; be sure to incorporate patient/family ideas

Say something like: "I have some suggestions that have helped other patients in the past in situations similar to yours. May I share them with you?"

Range of possibilities might include: patient education materials / websites; speaking with social worker, local clergy, school counselor; seeking out support group, referral to therapist / community mental health center.

Ask about their readiness to act on this now or in the future.
Say something like: "Is this (suggested plan) something you would be willing to do when you leave today, or if you need it next week...month?"

Ask about barriers to potential plans / referrals, and strategies to overcome barriers.
Say something like: "What kinds of things would interfere with following-up on this plan we just discussed? How can we work through this so you end up getting the help you need.?"

Involve the child and parent in setting the agenda*:*Adapted from Wissow et al. (2008)

Keep the door open.

If your patient or their parents are not quite ready to act on a suggested referral now, arrange to follow up to see how your patient is doing.

You might say: "I'd like to talk with you again in a few weeks to see how things are going."

Promote continuity of care.
If your care for this patient is ending, ask permission to communicate your concerns about traumatic stress reactions or risk factors to the child's primary care provider, or to other providers who will continue to take care of this patient.

Facilitating collaboration between pediatric health care and mental health providers: The American Academy of Pediatrics Task Force on Mental Health has developed tools to facilitate collaboration between pediatric health care providers and mental health professionals, including a Physician Referral and Feedback Form template

Effective mental health treatment for traumatic stress

There are very good and helpful treatments for children who continue to have traumatic stress symptoms.
What treatment approaches are effective?
Evidence-based treatments include cognitive-behavioral treatment approaches, and in particular Trauma-Focused Cognitive Behavior Therapy (TF-CBT).

Click here for a fact sheet about effective treatments for youth trauma from the National Child Traumatic Stress Network.

A recent article includes informative summaries of effective mental health treatments for child traumatic stress symptoms, and guidance for health care professionals:
Cohen, J, Kelleher, K, Mannarino, A.. Identifying, treating, and referring traumatized children: The role of pediatric providers. Archives of Pediatric and Adolescent Medicine 2008;162(5):447-452 How can I help parents find effective treatment for their child?
When helping parents find a counselor or therapist to help their child with traumatic stress symptoms, you might suggest that they ask prospective therapists questions such as:

Do you have experience working with children after trauma?

What is your approach to working with this type of problem?

What is your success rate?

How do you work with parents?

The National Child Traumatic Stress Network offers useful tips and information about finding a mental health professional to help children and their families after trauma.

Online resources - help in finding a mental health professional

The National Child Traumatic Stress Network (NCTSN) has trauma-trained, child mental health professionals and community-based treatment centers in 35 states in the US. For information about or referral to a NCTSN center near you, please go to the NCTSN Organizational Members site.
American Psychological Association - Psychologist Locator National Association of Social Workers - Find a Licensed Social Worker American Academy of Child and Adolescent Psychiatrists - Psychiatrist Finder Anxiety Disorders Association of America - Find a Therapist Sidran Institute Help Desk - Locate Trauma Resources ISTSS Clinician Directory - Find a Clinician, Counselor or Mental Health Professional
Distinguishing between types of mental health professionals

Psychologists are professionals who have earned a doctoral degree (Ph.D. or Psy.D.) after 4-6 years of graduate-level training in human behavior and development, psychological testing and evaluation, and psychotherapy. Psychologists are licensed by the state in which they practice.

Psychiatrists are physicians (M.D. or D.O.) who have completed medical school, plus additional advanced training in the evaluation and treatment of psychiatric disorders and emotional and behavioral problems. Psychiatrists are licensed by the state in which they practice. As medical doctors, psychiatrists can prescribe and monitor medications.

Clinical Social Workers are professionals who have earned a master's degree (M.S.W.) after 2-3 years of graduate training. Clinical Social Workers are licensed by the state in which they practice (LCSW or similar credential - varies by state).

Marriage and Family Therapists are professionals who have completed a master's degree (M.A. or M.S.) after 2-3 years of graduate training. Some Marriage and Family Therapists have completed a required amount of clinical hours and passed a state-administered examination to become licensed marriage and family therapist (LMFT).

Licensed Professional Counselors (LPC) & Licensed Mental Health Counselors (LMHC) are mental health professionals who have earned a master's degree (M.A. or M.S.) after 2-3 years of graduate training and have obtained a required amount of clinical experience and passed a state-administered licensing examination.

For more information on the training and credentialing of mental health professionals, see Mayo Clinic: Mental health providers.

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When and How to Refer for Mental Health Care

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Pediatric providers can follow specific steps to determine if and how to refer a child and familiy for further mental health services after a medically traumatic event. Providers can also become familiar with current evidence-based treatments and online resources for mental health services for traumatic stress.

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Responding to the Increased Needs of College Students

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Responding to the Increased Needs of College Students

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Successful Referrals in College Counseling

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Successful Referrals in College Counseling

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Successful Referrals in College Counseling

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School-Based Approaches in Youth with Psychosis

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School-Based Approaches in Youth with Psychosis

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