Get Skilled Up - ACT as an Adjunctive Treatment for OCD
The International OCD Foundation (IOCDF) recommends Acceptance and Commitment Therapy (ACT) as an adjunctive therapy to the first line treatment of Exposure and Response Prevention (ERP) https://iocdf.org/about-ocd/ocd-treatment-guide/ . Adjunctive treatments can enhance the outcomes of primary therapies.
At our centre we highly recommend using ACT to enhance ERP because both the centre directors (Stu and Jonny) have benefited greatly using ACT in their own OCD recoveries. We have also seen many clients that either didn’t benefit fully from ERP alone, or even had difficulties with ERP, that were greatly helped by learning ACT skills to complement ERP.
ACT enhances ERP by:
Providing skills to use during exposures to assist in ‘response prevention’ to help you feel willing and ready to engage in ERP
Giving tools to accept the presence of intrusive thoughts and interrupt mental compulsions – giving more options than just ‘stop ruminating’
Making room for intense emotions and sensations – providing more guidance than simply ‘sitting with the feelings’
Introducing tools to ‘surf’ the urges to do compulsions
Enabling you to build and connect more strongly to your recovery motivation using values, goals and workability reflections
Linking the ERP tasks more directly to values & goals and what you value in life
Giving tools to build self-compassion to work with shame and guilt that might block ERP
Providing tools to work with trauma, attachment history, difficult relationships, the full range of emotions and helping the whole person
Building a stronger sense of self-efficacy and self-belief that you are strong and resilient through skills training
Developing skills to use in the moment in response to OCD triggering outside of formal ERP tasks
Providing tools to work with overwhelm, if you engage in ERP that your skills are not ready for, and you experience significant OCD backlash
How can we build these ACT skills before applying them in ERP?
Here is a simplified list of ACT skills, drawing on inspiration from the work of Russ Harris, that can support ERP and lay the foundation for OCD recovery:
Dropping Anchor – learning to mindfully step back and observe thoughts and feelings. Building the ability to engage our attention in a flexible way.
https://youtu.be/04eDAC6cJmk?si=N8AmuhIKdDD8UavR
Urge Surfing – learning to surf the urge to do compulsions and to accept painful emotions.
https://youtu.be/ueVKiGO7lug?si=JzzPRDyGW6T2S4ub
Dipping in and out of the stream – working on mental rumination and how to get out out of mental compulsion loops.
https://youtu.be/NRFPsZv1dKc?si=h-lsVbb1qMMyJU89
Self-compassion – building self-compassion to support throughtout the process of ERP.
https://youtu.be/A3g0T0MW9Hs?si=OK-6evrRNmywOdBw
Values Based ERP – here are examples of applying these skills in ERP
https://youtu.be/ypUXMll-_sc?si=eboKTqNUm3DVLHlo
https://youtu.be/mh5IGsKSq0U?si=2lqinrfVFB_gOXRV
https://youtu.be/oalC1gJAgEw?si=PrqQCcAiIoGRI7YN
If you would like to work with a therapist who is skilled in this integration then please reach out to us. We work with international clients also.