#26 Dr. Helen Blair Simpson Discusses the Latest Treatment for Obsessive Compulsive Disorder 'OCD'

Dr. Deborah Korn is a clinical psychologist in private practice in Cambridge, Massachusetts, and an adjunct training faculty member at the Trauma Research Foundation in Boston. Dr. Korn is a senior faculty member at the EMDR Institute where she has been on staff for the past 28 years. She is an EMDRIA Approved Consultant and serves on the editorial board of the Journal of EMDR Practice and Research. EMDRIA is the organization focused on promoting, fostering, and preserving the highest standards of excellence and integrity in EMDR research, treatment, and education both in United States and internationally. Dr. Korn has authored, or coauthored numerous articles and chapters focused on EMDR therapy, including comprehensive reviews of EMDR applications with Complex PTSD. Her most recent book chapter, written with the developer of EMDR, Dr. Francine Shapiro, is included in the second edition of Treating Complex Traumatic Stress Disorders in Adults, which was published in 2020. I encourage everyone to check out her new book Every Memory Deserves Respect: EMDR, the Proven Trauma Therapy with the Power to Heal, co-written with Michael Baldwin, a trauma survivor and EMDR client (not her own).

EMDR, a memory-focused psychotherapy developed by Dr. Francine Shapiro in the late 1980's, is now recognized in the treatment guidelines of organizations around the world as a top-tier, evidence-based treatment for PTSD.  The theory or model that guides EMDR therapy is the Adaptive Information Processing Model (AIP Model).  It proposes that psychological problems are due to a failure to adequately process traumatic experiences to a point of “adaptive resolution”. During EMDR sessions, the client attends to emotionally disturbing material in brief sequential doses while simultaneously focusing on some form of external stimulation. Therapist-directed lateral eye movements are the most frequently used external stimulus but a variety of other stimuli, including hand-tapping and audio stimulation, are also used.  Research also supports EMDR's effectiveness with other problems not obviously trauma-related—depression, anxiety, psychosis, pain, obsessive compulsive disorder, substance abuse.  It can be used to treat people dealing with single traumatic events as well as those dealing with a history of prolonged, repeated exposure to trauma in childhood or as an adult.  It is used with people of all ages and can be administered, individually or in groups, immediately after an acute traumatic episode.  A recent meta-analysis found that EMDR was not only clinically effective but also the most cost-effective of the eleven trauma therapies evaluated in the treatment of adults with PTSD (Mavranezouli et al., 2020).

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Disclaimer: The information shared in this podcast is not a substitute for getting help from a mental health professional.

Dr. Nicole Stadnick is a Psychologist, Assistant Professor in the Department of Psychiatry at the University of California San Diego, Director of Dissemination and Evaluation of the Altman Clinical and Translational Research Institute Dissemination and Implementation Science Center and investigator in the Child and Adolescent Services Research Center. A primary area of Dr. Stadnick’s research aims to promote equitable access to evidence-based practices and mental health services for children with Autism Spectrum Disorder and co-occurring mental health needs through tailored service delivery models. She currently leads several implementation projects supported by the National Institutes of Health focused on community-engaged, cross-system health services and implementation research for individuals with complex clinical presentations including publicly funded mental health services and HIV AIDS care programs.

Autism spectrum disorder (ASD) is a construct that describes a constellation of social communication difficulties and restricted, repetitive patterns of behaviors or interests that have strong genetic underpinnings and appear early in life. People on the autism spectrum often have difficulties with social, emotional, and communication skills. They might also repeat certain behaviors or have a hard time changing routines or daily activities. Signs of ASD emerge during early childhood and typically last throughout a person’s life (American Psychiatric Association, 2013).

To address the documented disparities in access and receipt of evidence-based care for autistic individuals, service models are increasingly focused on ways to promote equity in access and reach. Primary care is well-positioned to reach those who may be at most risk of facing health disparities. Examples in primary care include the Extension for Community Healthcare Outcomes (ECHO) program and the Access to Tailored Autism Integrated Care model, both which are accumulating evidence for feasibility, acceptability, and adoption (Stadnick et al., 2019; Stadnick et al., 2021).

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Disclaimer: The information shared in this podcast is not a substitute for getting help from a mental health professional.

Dr. Elizabeth Nielson is a co-founder of Fluence and a psychologist with a focus on developing psychedelic medicines as empirically supported treatments for PTSD, substance use problems, and mood disorders. Dr. Nielson is a Site Co-Principal Investigator and therapist for an FDA approved Phase 3 clinical trial of MDMA-assisted Psychotherapy for Post-Traumatic Stress Disorder and has served as a therapist on FDA approved clinical trials of Psilocybin-Assisted treatment of Alcohol Use Disorder, psilocybin-assisted treatment of treatment resistant depression, and earlier phase 2 and 3 trials of MDMA-assisted psychotherapy. Through Fluence, she provides continuing education and training programs for therapists who wish to engage in integration of psychedelic experiences in clinical settings. Having completed an NIH postdoctoral fellowship at NYU, she has published and presented on topics of psychedelic therapist training, therapists’ personal experience with psychedelics, and including psychedelic integration in group and individual psychotherapy.

Psychedelic-Assisted Psychotherapy is a technique that involves the use of drugs that produce a psychedelic effect in order to assist in the psychotherapy process. The U.S. Food and Drug Administration (FDA) named psilocybin-assisted therapy as a “breakthrough therapy.” Over the last two decades, researchers have received approval from governmental authorities to conduct trials on the use of the psychedelic substances to treat various conditions. What researchers have found is that psychedelic substances can have beneficial therapeutic effects. According to the research, there are a number of potential applications for psychedelic therapy such as anxiety, depression, substance use, alcohol use, and PTSD. At present, there are multiple clinical trials on psychedelic assisted therapy, some in phase II and III. While psychedelics have the potential to help treat a number of mental health conditions, it is important to remember that these are powerful substances that can produce profound mind-altering effects. While psychedelic assisted psychotherapy is generally considered safe, there are potential risks such as negative psychological reactions, danger in self-treatment, and personality changes.

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Psychedelic Harm Reduction and Integration: A Transtheoretical Model for Clinical Practice

Twitter @Fluencetraining

Disclaimer: The information shared in this podcast is not a substitute for getting help from a mental health professional.

Dr. William R. Miller is Emeritus Distinguished Professor of Psychology and Psychiatry at the University of New Mexico, with over forty years of experience in teaching. Dr. Miller is a researcher and developer of the therapeutic model Motivational Interviewing. His many books include Motivational Interviewing: Helping People Change and Quantum Change: When Epiphanies and Sudden Insights Transform Ordinary Lives. Dr. Miller's latest book, Listening Well: The Art of Empathic Understanding, was released in January 2019.

Motivational Interviewing is a collaborative conversation that strengthens a person's own motivation for and commitment to change. It is a client-centered therapy that addresses the common problem of uncertainty around change. It focuses on exploring and working through ambivalence and centers on motivational processes within the individual that help to process the change. This method differs from more externally-driven methods for motivating change as it does not impose change. Rather, Motivational Interviewing supports change in a way that is congruent with the personal own values and concerns. Having conflicted feeling about behavior change is considered a normal part of the change process. Motivational Interviewing is an interpersonal style, not at all restricted to formal counseling settings. It is a subtle balance of directive and client-centered components shaped by a guiding philosophy and understanding of what triggers change.

Rereleased from Therapy Show Podcast Episode #12

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Disclaimer: The information shared in this podcast is not a substitute for getting help from a mental health professional.

Dr. Stefan Hofmann is a professor in the clinical program at Boston University and the Director of the Psychotherapy and Emotion Research Laboratory at the Center for Anxiety and Related Disorders. Some of Dr. Hofmann’s research questions include: Why are psychological treatments, such as cognitive-behavioral therapy, effective for anxiety disorders? What is the mechanism of treatment change, and what are the active ingredients? How can these treatments be improved further? Dr. Hofmann is the Editor in Chief of Cognitive Therapy and Research and is Associate Editor of Clinical Psychological Science.  Dr. Hofmann is the co-author of Abnormal Psychology: An Integrative Approach,Essentials of Abnormal Psychology, and Process-Based CBT: The Science and Core Clinical Competencies of Cognitive Behavioral Therapy. I encourage everyone to check out Dr. Hofmann’s new book, the Anxiety Skills Workbook, which was recently published in April, 2020.

Anxiety Disorders are different from normal feelings of fear or worry because they are excessive and can impede functioning. People suffering from anxiety disorders have a more chronic and extreme form of anxiety and develop behaviors that help avert anxious feelings. The type of anxiety disorder that a person experiences can be identified by the type of objects or situations that cause anxiety or avoidance behaviors. Generalized Anxiety Disorder is when a person worries excessively most days of the week for at least six months about many situations and finds it challenging to stop worrying. Some of the symptoms experienced include difficulty concentrating, becoming tired, restless, irritable, sleep problems, and muscle tension. Anxiety disorders can affect school and work performance and hinder personal relationships and social environment.

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Disclaimer: The information shared in this podcast is not a substitute for getting help from a mental health professional.

Dr. Ingmar Gorman is a co-founder of Fluence, a psychedelic education company training mental health providers in psychedelic treatments. As a psychologist, he shares his expertise in empirically supported psychedelic treatments with his clients and trainees alike. Dr. Gorman received his clinical training in New York City at the New School for Social Research, Mount Sinai Beth Israel Hospital, Columbia University, and Bellevue Hospital. He completed his NIH postdoctoral fellowship at New York University. He simultaneously served as site co-principal investigator on an FDA approved Phase 3 clinical trial of MDMA-assisted Psychotherapy for Post-Traumatic Stress Disorder and is currently a study therapist on the same study, as well as another FDA approved clinical trial of psilocybin for treatment resistant depression. Dr. Gorman has published on the topics of classic psychedelics, ketamine, MDMA, and Psychedelic Harm Reduction and Integration.

Psychedelic-Assisted Psychotherapy is a technique that involves the use of drugs that produce a psychedelic effect in order to assist in the psychotherapy process. The U.S. Food and Drug Administration (FDA) named psilocybin-assisted therapy as a “breakthrough therapy.” Over the last two decades, researchers have received approval from governmental authorities to conduct trials on the use of the psychedelic substances to treat various conditions. What researchers have found is that psychedelic substances can have beneficial therapeutic effects. According to the research, there are a number of potential applications for psychedelic therapy such as anxiety, depression, substance use, alcohol use, and PTSD. At present, there are multiple clinical trials on psychedelic assisted therapy, some in phase II and III.

TherapyShow.com/Psychedelic-Assisted-Psychotherapy

Psychedelic Harm Reduction and Integration: A Transtheoretical Model for Clinical Practice

Twitter @Fluencetraining

Disclaimer: The information shared in this podcast is not a substitute for getting help from a mental health professional.

Dr. Steven Hayes is Nevada Foundation Professor at the Department of Psychology at the University of Nevada and the developer of a new approach to human thought called Relational Frame Theory. He has guided ACT’s extension to Acceptance and Commitment Therapy (ACT) a popular evidence-based form of psychotherapy that is now practiced by tens of thousands of clinicians all around the world. Dr. Hayes was listed by the Institute of Scientific Information as the 30th “highest impact” psychologist in the world. Dr. Hayes is the author of many seminal books includin Acceptance and Commitment Therapy and my favorite Acceptance & Mindfulness Treatments for Children & Adolescents: A Practioner’s Guide. Whether you are a client or therapist, I encourage you to read his new book A Liberated Mind: How to Pivot Toward What Matters.

ACT uses mindfulness and acceptance skills to help individuals respond to uncontrollable experiences with behavior that is more consistent with their personal values and goals. A therapy model where clients learn to accept their inner thoughts, emotions and sensations and begin to practice psychological flexibility which is demonstrated by more adaptive behaviors. ACT teaches individuals to deal with their emotional and mental struggles through a balance of acceptance of their problems and encouraging them to move toward more adaptive change. In contrast to most Western psychotherapy which is based on a medical model, ACT does not have symptom reduction as a primary goal. This is based on the belief that the attempt to get rid of symptoms can actually cause a clinical disorder. As soon as individual’s experience is labeled a symptom, they begin to fight against that symptom in order to eradicate it. In ACT therapy, a person would look to have a new relationship with their difficult thoughts and feelings, change their perspective on them as harmless, albeit uncomfortable, transient psychological experiences. It is through this process that clients utilizing an ACT modality actually achieves a reduction in their psychiatric symptoms.

Re-released from Therapy Show Episode 9

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Dr. Steven Hayes on Twitter: @StevenCHayes

Disclaimer: The information shared in this podcast is not a substitute for getting help from a mental health professional.

Dr. Elaine Walker is the Charles Howard Candler Professor of Psychology and Neuroscience at Emory College’s Department of Psychology and her research focuses on the precursors and neurodevelopmental aspects of psychopathology of schizophrenia. Schizophrenia and other psychotic disorders are major mental illnesses that involve an abnormality in central nervous system functioning. Dr. Walker’s research program is concerned with shedding light on the nature and origins of this abnormality, its interaction with neuromaturational processes and the role of environmental stressors in triggering psychotic episodes. Her team is studying the prodromal period of adult-onset psychosis in order to identify manifestations of dysfunction and the predictors of conversion to clinical psychosis. The focus is on exploring the relations among clinical symptoms, neuromaturational processes, neuropsychological functions, and Central Nervous System development. She is leading the Mental Health and Development Research Program supported by the National Institute of Mental Health. Dr. Walker is the co-author of Abnormal Psychology (2001) and co-editor of Adolescent Psychopathology and the Developing Brain: Integrating Brain and Prevention Science (2007) as well as co-editor of Schizophrenia: A Life-Course Developmental Perspective (1991).

Schizophrenia is a serious illness that affects thinking, emotions, behavior and psychosocial functioning. Psychotic symptoms can include hallucinations, delusions, and disorganized thinking and are prominent symptoms in Schizophrenia.  Individuals suffering with Schizophrenia may seem internally preoccupied or may be observed responding to internal stimuli. The more psychotic aspects of Schizophrenia generally emerge between the late teens and mid-30s, although prodromal symptoms (slow and gradual development of signs and symptoms of the disorder) are usually apparent sooner and may manifest in social withdrawal, stranger habits, or a decline in academic performance. The severity of Schizophrenia can range from significant cognitive and emotional disability to somewhat milder social and occupational limitations. Individuals with milder forms of Schizophrenia may complete school, hold jobs, and start a family. 

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Disclaimer: The information shared in this podcast is not a substitute for getting help from a mental health professional.

Dr. Frederic Reamer is a Professor in the School of Social Work at Rhode Island College for over 30 years.  He received his PhD from the University of Chicago and has served as a social worker in correctional and mental health settings. Dr. Reamer chaired the national task force that wrote the National Association of Social Workers Code of Ethics adopted in 1996 and recently participated in drafting new Technology Standards added to the code in 2017.  Dr. Reamer lectures both nationally and internationally on the subjects of professional ethics and professional malpractice and liability. He has conducted extensive research on professional ethics and has been involved in several national research projects sponsored by The Hastings Center, Carnegie Corporation, Haas Foundation, and Center for Bioethics of the University of Pennsylvania. Dr. Reamer is the author of many books, including: Boundary Issues and Dual Relationships in the Human Services; Risk Management in Social Work: Preventing Professional Malpractice, Liability, and Disciplinary Action; The Social Work Ethics Audit: A Risk Management Tool and On the Parole Board: Reflections on Crime, Punishment, Redemption, and Justice; Ethics and Risk Management in Online and Distance Social Work; and his latest, Moral Distress and Injury in Human Services, among others. Dr. Reamer’s journal article Ethical Standards for Social Workers' Use of Technology: Emerging Consensus is the most comprehensive discussion of recently adopted regulatory, ethics, and practice standards to date.

Dual Relationships and Boundary Crossings: Social workers often encounter circumstances that pose actual or potential boundary issues where they may face conflicts of interest in the form of dual relationships. Dual relationships occur when social workers engage with clients or colleagues in more than one relationship outside of their professional relationship such as participating in business, sexual, social or religious activities. Some dual relationships are unethical (for example, when social workers exploit clients), and some are not (unintended encounters outside therapy). Further, some dual relationships are avoidable, and some are not (for example, when social workers and clients live in small or rural communities). 

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Disclaimer: The information shared in this podcast is not a substitute for getting help from a mental health professional.

Dr. Elizabeth Dexter-Mazza is licensed psychologist, a certified DBT therapist and co-author of the DBT STEPS-A social emotional learning curriculum for middle and high school students. Dr. Dexter-Mazza completed her postdoctoral fellowship under the direction of Dr. Marsha Linehan at the Behavioral Research and Therapy Clinics (BRTC) at the University of Washington. While at the BRTC, she was the Clinical Director and a research therapist for Dr. Linehan’s research studies, which provided both individual DBT and DBT group skills training. Dr. Dexter-Mazza is the co-author of DBT Skills in Schools: Skills Training for Emotional Problem Solving for Adolescents (DBT STEPS-A). She has published several book chapters and peer reviewed articles on DBT, Borderline Personality Disorder (BPD), and graduate school training in how to manage suicidal clients. Dr. Dexter-Mazza is considered an expert in training mental health professionals around the world in DBT. She also provides consultation on the implementation of DBT and DBT STEPS-A to clinicians and schools.

Dr. James J. Mazza has a Ph.D. in school psychology and the co-author of the DBT STEPS-A social emotional learning curriculum for middle and high school students. Dr. Mazza is a professor at the University of Washington – Seattle where he has been for the past 20 years teaching and conducting research in the field of adolescent mental health.  Dr. Dexter-Mazza is the co-author of DBT Skills in Schools: Skills Training for Emotional Problem Solving for Adolescents (DBT STEPS-A). Dr. Mazza’s research interests focus particularly on adolescent internalizing disorders such as depression, anxiety, posttraumatic stress disorder, exposure to violence and especially suicidal behavior. He examines the complex relationships of how mental health issues impact adolescent social emotional abilities and academic skills through a multitiered system of supports.   Dr. Mazza’s focuses on school-based settings and has written extensively through peer-reviewed articles and book chapters on how to identify youth who are at-risk for suicidal behavior as well as developing social emotional learning (SEL) curricula to help all students learn emotion regulation skills.  

DBT in Schools has developed the DBT Steps-A skills training and social-emotional problem-solving curriculum for adolescents. The curriculum was developed to be implemented in middle and high schools in order to teach all adolescents effective emotion regulation, decision making, and problem-solving skills. The DBT STEPS-A curriculum includes 30 lesson plans that are designed to fit within a general education curriculum. Each lesson is 50 minutes long. The curriculum was adapted from the skills training program in Dialectical Behavior Therapy developed by Dr. Marsha Linehan, Professor at the University of Washington (Behavioral Tech, n.d.). 

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Disclaimer: The information shared in this podcast is not a substitute for getting help from a mental health professional.