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I'm desperate to help my daughter help herself.  She has struggled since she went to University last autumn and  her OCD has  become a  lot worse.   Despite making friends and liking her university and  demanding course, it is an intense environment.   She now finds it takes hours to get in to bed to sleep as well as all the intrusive thoughts and compulsions during the day  and  it reached a crisis point last week and she came home for a few days just to sleep.  Finding a  private therapist was critical as she is on a NHS 8 month waiting list for cbt therapy.   It came down to a choice of a well known OCD expert by skype who is very expensive or a local to her university BABCP therapist who is not an OCD expert,  she was declined by another well regarded therapist.  Choosing the local therapist she has now had 3 sessions but so far has only been given relaxation techniques and told the therapist needs to go into her history more.   During her crisis period at home I spent many hours building on my OCD knowledge and we started to do some ERP as a practice in readiness for therapy and because quite frankly there seemed to be nothing to lose as the likelihood of dropping out of university loomed.  Having built a hierarchy for home and at university and charted a very long list of her overt and covert compulsions with her  just makes me feel that her therapist really needs to know what they are doing with this deeply entrenched illness.   We both found hope in starting the ERP together, having carefully chosen from the hierarchy something manageable but not overwhelming.  There was a chink of light for my daughter that this was the way forward.  Doing ERP very late at night in her room at uni seems much less manageable and I feel very disappointed that no ERP has started after three weeks of therapy.

Medication wise she was on a low dose of fluoxetine and the university local gp put her on a higher dose which seemed to bring about a lowering of mood so she dropped back to the lower dose which I am sure is probably useless, she is having to wait 2 weeks for another appointment to ask if she can try another drug? The appointments are a strict 5 minutes so I don't expect much consideration.

As her mum, I do not want to take on the role of a therapist or advise on medication but yet again I find myself doing anything I have to help her,    I don't think she will last long without sleep until she is back home. Should we cut our losses and move on  to an expert  OCD therapist or is CBT ERP typically very slow starting

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Hi jenpen,

Welcome to the forum. I've also been down the privately funded therapy route, the waiting times through the NHS were much the same as your daughter's experience. It's shame we have to navigate the system like this, hopefully one day it will improve.

23 hours ago, jenpen said:

Should we cut our losses and move on  to an expert  OCD therapist or is CBT ERP typically very slow starting

CBT is quite a gradual process, it wouldn't be normal practice for a therapist to immediately begin ERP exercises with a client, even if they'd done some earlier groundwork at home. 

That said, devoting three sessions to relaxation techniques does strike me as pretty excessive within the average treatment timeframe of around 10 to 20 sessions depending upon the severity of the OCD.

That concerns me a little.

Going into your daughter's history hopefully means looking at the nature of the thoughts and the compulsions etc....I'd be worried if it means examining her childhood and what may have precipitated the anxiety/OCD. I'd have no hesitation if that were the case in walking away and finding another therapist.

CBT's about focusing on the here and now, not the past.

It's very difficult to know how best to advise you...you could give your daughter's current therapist the benefit of the doubt for one more session, and ask them to go into more detail about the treatment process. They could very well turn out to be excellent but I think you need a much clearer roadmap and have every right to ask for it. You might already have come across it, but the charity's produced these guidelines covering finding a private therapist, available here that might be helpful:

https://www.ocduk.org/overcoming-ocd/accessing-ocd-treatment/accessing-ocd-treatment-privately/finding-a-private-therapist/

In terms of medication that's also quite tricky to advise you on, other SSRIs are obviously available to your daughter to try, but it tends to be a case of trial and error with them...what works for one person won't another. Would your daughter be okay with you perhaps getting a second opinion from your local GP?

In the meantime, I think your daughter should try and keep going with the exposure exercises you've done so much to help her with. That's important.

I hope whatever way to decide to go, your daughter starts to feel the benefit from the CBT and can be free from the disorder. I think she's very lucky to have someone who's so supportive and prepared to do so much to help her through this.

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Hal, thank you very much, it really is an enormous help to hear from someone else.  I just feel determined to help my daughter find a way out and to fight for her chance to be happy at university without it all going wrong.  I think  the idea of one more session is a good one with a frank conversation about the roadmap.   In the meantime I will carry on with the exercises we have started.  I think people think a mother should not step into the role of therapist and you should leave everything to professionals but really you could call me an accountability partner and that must be better than being on your own late at night with no strategy or feedback.   

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9 hours ago, jenpen said:

I think people think a mother should not step into the role of therapist and you should leave everything to professionals but really you could call me an accountability partner and that must be better than being on your own late at night with no strategy or feedback.   

I think its absolutely brilliant that you want to and are willing to work with your daughter.  You seem incredibly well informed and capable!  Your daughter is lucky to have you in her corner.  Society may think that 18 year olds are suddenly magically adults and capable of doing everything all on their own, but adulthood was more of a process for me than a single moment and I think thats true of just about everyone!  I see nothing wrong with continuing to support your daughter in reasonable ways and help advocate for her.  If you were her spouse you'd probably be that involved too and no one would blink an eye at it.  Since she doesn't have that option, having a parent help seems totally rational to me!

One idea ii had that maybe you can try, would it be possible to video chat with your daughter and continue working on ERP together?  Maybe it would help her having that consistency at least some of the time so she doesn't spend so much time struggling on her own at night.

Also, perhaps its possible to reduce some of her course workload through the university.  I'm not entirely sure of the nature of British Universities, but maybe taking one less class each term would give her enough of breathing room to handle both the OCD and her education.  I would hope the school is willing to make (and maybe legally required to make) accommodations for disabilities like OCD.

I hope things work out for you and your daughter soon.

 

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dksea thank you, I think the video chat is a great idea, we can give that a go today.   The university have been good and she is officially 'disabled' and is able to retake exams etc  if necessary,  I guess an intensive course is good for keeping very busy but not so good for being under pressure to keep up.   In some ways the OCD has been brought to a head by leaving home and  she has had to start battling it properly or end up back at home.  I have also had to take a deeper dive in to understanding OCD and its treatment.   When you don't see all the covert compulsions it's easy to be complacent, now that we have mapped things out I can see the problem more clearly.  It means a lot to get some real hope from people who have recovered. 

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I had to take a year out between second and third year of Uni because I had a crisis -- just in case it helps to hear that this can happen. Is she receiving Disabled Students Allowance? I was allocated an hour a week from a mental health support person. Not a therapist, but someone who could help me keep on track with studies, touch base with. One time, when I was becoming quite unwell, they came with me to the GP to advocate for me. They were also great at helping me navigate the extenuating circumstances process.

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