Obsessive-Compulsive Disorder (OCD)

Obsessive-Compulsive Disorder (OCD)

Personality disorders are mental health illnesses characterized by chronic patterns of maladaptive and pervasive cognition, behavior, and mood. Paranoid personality disorder, narcissistic personality disorder, obsessive-compulsive disorder, and antisocial personality disorder are some of the recognized disorders in the personality spectrum of disorders highlighted in the DSM-5-TR. This paper analyzes obsessive-compulsive personality disorder.

Description of Obsessive-Compulsive Disorder

Obsessive-compulsive disorder (OCD) is one of the most common personality disorders. It is characterized by a repetitive pattern of compulsion and obsession that results in significant distress and impairment in the social functioning of an individual (Singh et al., 2023). OCD diagnosis is a clinical diagnosis based on a comprehensive assessment to ascertain an alignment with the diagnostic criteria detailed in the DSM. According to the DSM, a positive diagnosis of OCD is made in the presence of either obsession or compulsions. The obsessive or compulsive thought processes must consume a significant amount of time, as demonstrated by episodes of one hour or more per day, and cause substantial disruptions in an individual’s daily life. The symptoms must also not be attributed to any other medical condition (American Psychiatric Association, 2022).

Therapeutic Approach and Modality for Patients with OCD

Comprehensive management of patients with OCD integrates psychotherapeutic and pharmacotherapeutic modalities. The choice of either is often pegged on the severity of the condition. A patient presenting with OCD may benefit from cognitive behavioral therapy (CBT) in an individual therapy approach. CBT is a psychotherapeutic intervention that is the first line in the management of OCD (Singh et al., 2023). A CBT technique of exposure and response prevention is one of the most used and substantiated approaches within the CBT framework. It involves subjective persons with OCD to provocative stimuli while working with them to abstain from subsequent compulsive thoughts or behaviors targeting to offset the provocative stimuli. The individual approach was selected as it provides a more confidential option and allows one-on-one attention to be accorded to the client (Singh et al., 2023). Pharmacotherapy may be an option whenever symptoms are severe and when psychotherapy is not optimal. Selective serotonin reuptake inhibitors (SSRIs) are the first-line options in the pharmacotherapeutic management of OCD (Swierkosz-Lenart et al., 2023).

The Therapeutic Relationship in Psychiatry

The therapeutic relationship in psychiatry is the normative connection between the therapist and the client required for the effective management of psychiatric illnesses. It is a connection built on mutual respect, trust, and a sense of hope. The therapist, in this respect, instills a sense of hope in the client, allows the client to respect themselves, and engages them in decision-making processes (El‐Abidi et al., 2023). To share a diagnosis with a client without destroying therapeutic trust, therapists must utilize best practices in therapeutic communication. In this case, they must communicate the diagnosis at the right time and not wait for too long before conveying the diagnosis. Likewise, they should offer reassurance, maintain patience, avoid assumptions about therapeutic options and prognosis, and demonstrate active listening during the communicative processes. Sharing the diagnosis may differ with the setting. When sharing the diagnosis with the individual patient, open communication is encouraged, accompanied by appropriate education on the disease process. Communicating with the family is likewise important and can be done similarly with the individualized approach, as families are integral to the comprehensive management of OCD. However, when sharing a diagnosis through the group approach, the therapists should first ensure that persons with similar complaints are included to eliminate the potential stigma associated with personality disorders. They should also interrogate the client’s feelings and acceptability of the group approach.

References

American Psychiatric Association. (2022). Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision. American Psychiatric Association.

El‐Abidi, K., Moreno‐Poyato, A. R., Cañabate‐Ros, M., Garcia‐Sanchez, J. A., Lluch‐Canut, M. T., Muñoz‐Ruoco, E., Pérez‐Moreno, J. J., Pita‐De‐La‐Vega, J., Puig‐Llobet, M., Rubia‐Ruiz, G., Santos‐Pariente, C., López, A. M., Golmar, L. J., López, C. E., & Roldán‐Merino, J. F. (2023). The therapeutic relationship from the perspective of patients and nurses in the first days of admission: A cross‐sectional study in Acute Mental Health Units. International Journal of Mental Health Nursing, 33(1), 134–142. https://doi.org/10.1111/inm.13227

Singh, A., Anjankar, V. P., & Sapkale, B. (2023). Obsessive-compulsive disorder (OCD): A comprehensive review of diagnosis, comorbidities, and treatment approaches. Cureus. https://doi.org/10.7759/cureus.48960

Swierkosz-Lenart, K., Dos Santos, J. F., Elowe, J., Clair, A.-H., Bally, J. F., Riquier, F., Bloch, J., Draganski, B., Clerc, M.-T., Pozuelo Moyano, B., von Gunten, A., & Mallet, L. (2023). Therapies for obsessive-compulsive disorder: Current state of the art and perspectives for approaching treatment-resistant patients. Frontiers in Psychiatry, 14. https://doi.org/10.3389/fpsyt.2023.1065812

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Review this week’s Learning Resources and reflect on the insights they provide about treating clients with personality disorders.

Select one of the personality disorders from the DSM-5-TR (e.g., paranoid, antisocial, narcissistic). Then, select a therapy modality (individual, family, or group) that you might use to treat a client with the disorder you selected.

Succinctly, in 2– pages, address the following:

• Briefly describe the personality disorder you selected, including the DSM-5-TR diagnostic criteria.
• Explain a therapeutic approach and a modality you might use to treat a client presenting with this disorder. Explain why you selected the approach and modality, justifying their appropriateness.
• Next, briefly explain what a therapeutic relationship is in psychiatry. Explain how you would share your diagnosis of this disorder with the client in order to avoid damaging the therapeutic relationship. Compare the differences in how you would share your diagnosis with an individual, a family, and a group session.

Support your response with specific examples from this week’s Learning Resources and at least three peer-reviewed, evidence-based sources. Explain why each of your supporting sources is considered scholarly. Attach the PDFs of your sources.

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