Have you had online video therapy for OCD?

[Ashley]

Because of COVID-19 the NHS are fast tracking delivery of therapy online rather than face-to-face.  The specialists had been looking at starting to roll some of this out later in the year anyway, but because of the situation we all unexpectedly find ourselves in they are fast forwarding and across the country therapists are having to do this now.

The specialists are currently writing at the speed of light best practice for delivering therapy for various conditions remotely and we have been asked to try and put something together as guidance for service users to get the most our of video therapy for OCD.

I am already preparing some documentation with some initial thoughts, and we would welcome the input from the following two groups of people:

Those who have already had several sessions of CBT through video

• What worked
• What didn't work
• Did anything make you feel at ease, comfortable doing therapy that way
• Anything else
• Q from me. Would something as simple as getting dressed up, shaved/makeup like you would face-to-face make you feel more comfortable/confident to talk to a therapist 

 

Those who have had regular face-to-face CBT in the past but not through video

• Do you see limitations through video?
• What do you think would have helped you transfer those CBT in person to video?
• Any helpful ideas you have for video therapy

 

Just to be clear, the therapists will take care of the therapy side of things.  This is more a question about what can we recommend to help people feel more confident, engaged in and make the most out of the video therapy.

[malina]

I had a therapy session via Zoom and it worked really well. The only difficult thing was the idea of doing exposures in this way. In a way, doing the exercises at home, without the therapist physically there is a whole new level that I wasn't ready to go to yet. I think this can be good because it pushes you, but it's also much more challenging. I would imagine that it's also more challenging to do things like this if your fear involves something that has to be done outside the immediate environment. What if you're scared of lifts, but don't live in a building with a lift? I feel like some ERP exercises would have to be put on hold for this reason. Otherwise, I really liked it. 

[taurean]

I have recently, and thankfully successfully, completed a course of therapy face to face.

What really helped was that the therapist and I could look at documents together, placed on a table between us. For example we worked on revising my vicious flower diagram together, and  the 4-page wellness plan we produced together, when I was well again,  for me to use going forwards.

So , since this was a fantastic element of my therapy, I am not quite sure how that could be built into online sessions.

 

 

[Nikki79]

I had four sessions with my new Therapist and actually two of them have had to be online as government restrictions with Covid-19 here in Ireland mean I can’t go to her office and have a session face to face. I have to say I was unsure what it would be like online but my experience so far has been good. I would recommend using Skype or Zoom on a tablet or laptop as the first time I used my phone and the quality was poor. This can distract from the session for obvious reasons. What I like about the online sessions is my therapist sends a summary of the session after the session along with homework. I never got the summary in a typed document when it was face to face so I do quite like that. My personal opinion is you don’t need to dress up particularly as if you are going out to meet face to face for the session but certainly it’s important to have a quiet place to conduct it. I have a 17 month old toddler and if I can manage a session online ( once she is being minded) anyone can. Hope this helps. 

[OB1]

On 08/04/2020 at 13:11, Ashley said:

• Do you see limitations through video?
• What do you think would have helped you transfer those CBT in person to video?
• Any helpful ideas you have for video therapy

Hi Ashley,

I've had quite a bit of CBT over the years, some better than others but nothing with an OCD specialist, however here's my thoughts.

- I had EMDR for PTSD so don't know if that would work online (not CBT I know).

- Some people may not be able to find a quiet or private place at home, I guess that's a challenge with video.

- I think animation could and does really lend itself to this type of therapy, there's some great stuff out there, obvs it would need an expert check.

- Virtual reality headsets could really play a part.  VR is being used to treat PTSD and I'd have thought it could with CBT and some exposure work.

- Sound is really important, having a set of headphones on can make things seem more 3 dimensional when talking to someone via video link.

- The best thing is I think it has the potential for the therapist focus more on what each session will involve because this is going to make a lot of people rethink how CBT is delivered.

Hope that's useful.

Cheers and thank you for all the hard work you're putting in. 

 

[Ashley]

Thanks all, some really helpful thoughts here