Guest post: How nOCD App helps thousands with OCD- Obsessive Compulsive Disorder by Stephen Smith

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In the summer of 2014, I was tired of struggling with OCD, Obsessive compulsive disorder, so I decided to do something about it and begin my app, nOCD. nOCD, standing for “No OCD”, is an online platform that I believe would have helped me during the worst of my struggles and that currently is already helping thousands of others with OCD today. The platform is designed to help people with OCD during all four phases of treatment: 1) coping with the onset of OCD symptoms, 2) selecting a care team, 3) actively managing OCD treatment, and 4) maintaining OCD treatment progress.

My team and I at nOCD are able to address each phase of treatment using a unique combination of highly vivid content and 21st century technology. For instance, people with OCD can view our content on Instagram or Twitter at @treatmyocd and download nOCD for free on the App Store (m.treatmyocd.com/saveslives).

People with OCD say the app has been a major difference maker. It gives people guidance in the moment of OCD episodes, a structured platform to do Cognitive Behavioural Therapy (CBT) exercises, a community to talk with others (in beta), and real-time data 24/7. Here is more information about how it works:

  1. SOS Guidance: nOCD offers members clinically effective guidance in the moment of any OCD episode, using OCD specific Cognitive Behavioural Therapy. During an episode, members can hit the button “SOS” on their phone, which tells the app to immediately provide Mindfulness Based Cognitive Therapy and Acceptance Commitment Therapy (Response Prevention). For instance, if the member is obsessing, nOCD will ask questions such as: “Are you experiencing an Obsession or a Compulsion?”,  “What Obsession are you experiencing?”. “What triggered the Obsession?” And “How intense is your anxiety?” Then, based on the answers, nOCD will offer specific Acceptance Based Therapy guidance, to help the member effectively respond to the obsession without doing a compulsion. We believe the SOS feature can empower people with OCD to live their lives fully, knowing help is always in their pocket.

  2. Structured ERP ExercisesnOCD provides members with the tools and organization needed to consistently do planned OCD treatment exercises regularly and effectively, acting like a mental gym. The main challenge with doing these planned mental exercises is that they instigate anxiety. Since the anxiety alone can reduce OCD treatment adherence rates, the app attempts to remove all pain point. It offers members the ability to create loop tapes, scripts, and drawings. It also has built in exercise reminders and educational tips.

  3. Custom Therapy : nOCD customizes the entire treatment process to each member, helping augment therapy with licensed clinicians. Patients can customise their hierarchies, their compulsion prevention messages (acceptance based messages), their ERP schedule, and more.

  4. 24/7 In-App Support Group :Inside the nOCD app, people with OCD can join different support groups and anonymously post to each groups wall. We’ve created a platform where people can support each other through treatment and learn quickly that they are, in fact, not alone.
  5. Real-Time Data Collection: It collects real-time data about every aspect of the patient’s condition and treatment. It also longitudinally displays the data for every patient and clinician to see at any time. nOCD protects each users PHI data to the highest degree possible. For example, it uses a dedicated (encrypted) Ec2 instance on Amazon Web Services, SSL connection, Touch ID login access, LastPass Password security, and new, monthly, VM keys. nOCD is a HIPAA compliant commercial enterprise.

 

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Life Mental Health Update and the Liebster Award!

Its been a really interesting week for me. I firstly decided after not getting the right NHS therapeutic support that I had to take life into my hands in two ways. Firstly, I needed to see if I could get funding for private therapy to help my anxiety and panic attacks about work. I was able to and then I have booked an appointment to see a recommended psycho-dynamic counsellor. I am hoping that my counselling sessions will help the anxiety and fear around certain things.

Secondly, I decided that if I want to live my dreams and have a life that is fulfilling and true to myself, I have to pursue them. Obviously I have to make my dream achievable too so I have been applying for jobs that feel right for me. My dream has been to be a teacher and I hope to get there one day. I have been interviewing for various positions in schools and hopefully the right one for me will come up soon. I will leave it to God and the universe to decide and do all I can.

So, its been quite a whirlwind for me this week and definitely being pushed a little outside my comfort zone, putting my heart and dreams on the line. However, I am really proud of myself for doing this. I have wanted to seek therapeutic help for years and while its a shame I can’t get it for free on the NHS, I hope it helps me to change my life. My family are a great support for me with this. I am starting this week and will see what happens.

So I have been going to job interviews and its really scary being asked so many questions and waiting for feedback. I know though that I can do it and make myself and my family proud (I hope anyway!)

As well as the above, I am very excited to be going to see Aladdin the musical at the theatre with my boyfriend for our anniversary. He is a wonderful support to me and I love disney!

Lastly, a blog friend, the Happiness Hunter https://thehappinesshunt.wordpress.com   has nominated me for the Liebster Award which celebrates new blogs. My blog has been going almost 2 years but I feel so thrilled to receive the award. Thank you so much! Due to time constraints I can’t nominate other blogs for the award but dedicate it to all my blog followers who are battling mental health stigma and writing so amazingly.  

Go and visit the above blog too, its wonderful! Thanks again 🙂

liebster

On being kind to myself: Mental health update

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Life at the moment is much slower than normal as I am not in full time work. I have the time to write and blog and pitch articles, and to work on social media. I have the time to read and I have started a book blog (bookstagram) on Instagram. I can see friends and catch up with family.

However, for me, I am waiting to see my Doctor next week to discuss ways they can support me better with my morning panic. I desperately want to be working and be doing all I love. Its quite exhausting if I am honest, because I so want to be applying for jobs and doing and feeling 100 percent .

The key is being kind to myself and practising self care. I know I can get better again from the anxiety and be productive again but I need proper and sustained support from my medical team. I hope I can get it soon and that they will really help me. I have so much support from my family, boyfriend and friends but they can only do so much.

Life with this is not easy at all- but I know, like my other mental health challenges, that I will overcome this again. I just must have the support in place from my medical team and the right therapy. So lets hope that my almost 2 year wait for therapy will end soon!  I am reading self help books too in addition and trying to do all I can. I just hope that help for my anxiety disorder will finally arrive.

Guest post: What can the UK government do to cultivate good mental health? by Ann Heathcote at Worsley centre of Psychotherapy

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According to statistics revealed by mentalhealth.org.uk 65% of people in the UK have experienced a mental health problem in their lives at one time or another. What’s more revealing is that just a mere 13% of us say that we live with high levels of good mental health in our daily lives.

These stats suggest there is much to do to improve the state of our mental wellbeing, but to turn things around will require help from the powers that be, namely Government.

But is the UK Government doing enough to ensure that current and future societies have good mental health. And if you believe they could more, what action can be taken to fix this prevailing problem?

We reached out to some of the leading voices on mental health issues to get their opinion.

See full article at https://theworsleycentre.com/what-can-the-uk-government-do-to-cultivate-good-mental-health/

 

Ann Heathcote opened The Worsley Centre for Psychotherapy and Counselling in 2001, as a centre for the provision of professional psychotherapeutic services.

The Worsley Centre is a warm and welcoming environment for people wishing to undertake counselling and psychotherapy. The practitioners at the Centre care deeply about each individual’s mental health and well-being. They all share a passion for providing high quality therapeutic services.

Guest post by Karen: Being a Mental Health Professional with Anxiety, my Recovery

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Working in an outpatients’ mental health service in the NHS I was well-placed to recognise the signs and symptoms of a mental health problem. I have seen most ends of the spectrum from working in a secure men’s forensic unit, treating people experiencing psychosis in a clinic and in their homes, to treating outpatients with mild to moderate depression and anxiety. Yet none of this prepared me for my own mental health crisis that crept up on me suddenly and unexpectedly last year.

I have experienced anxiety in my life on many occasions before. I developed a fear of panicking and losing control going on the tube and was starting to avoid taking tubes and trains and places I felt I could not escape from easily. Later on I realised this was panic and agoraphobia and since I was considering dropping out of my Masters degree because it involved travelling long routes by tube, I knew I had to get some help. I had a course of CBT privately using graded exposure therapy which I had to get on board with and be committed to, and was incredibly effective for me. My CBT therapist was a real lifeline for me and we had an effective rapport which really helped.

I have since moved out of London and abroad. In September last year I started a number of new part-time teaching roles (not in mental health) in my relatively new European city. I was really worried about my ability to speak the language and to be able to communicate if there was a problem. In fact, I had pretty much spent my entire summer holiday dreading, worrying and catastrophising about all the things that could go wrong, and didn’t really tell anyone exactly how I was feeling.

I started in one of my jobs and it seemed to be going just fine the first week. I did experience a lot of worry after each class and before the next one. I was really concerned about how other people would perceive and judge me, particularly as I was not yet fluent in the language and could not understand 100%. I continued to be anxious about how other people thought I was doing my job for the next few days and had consistently negative thoughts that would not go away which were concerning as they seemed to upset me more and more. I remember that on the last day of that first week, I had been introduced to my new colleague, a really lovely lady who seemed really helpful. She was really experienced and obviously had a lot of knowledge and I started to feel inadequate in that moment. That was the moment everything spiralled out of control.

I went home and over the weekend I experienced constant racing thoughts of things going wrong and worst case scenarios. My husband and I were watching TV in the evening and I just could not focus on anything as my mind was racing so much. What surprised me the most was how physically I felt the anxiety this time and how different it was to any anxiety I had before this. I felt hot and cold every few minutes, had the sweats and could not sleep for days. I could not seem to regulate my emotions and rationalise them. I retreated to bed to warm up and calm down and called my mum for moral support. I lost my appetite and could physically not put anything in my mouth apart from forcing some sugar down me.

This pattern continued the closer it came to Monday. I found it really hard to get out of bed – I was heavy, anxious and tired due to lack of sleep. It was hard to sit up straight and I forced myself to have breakfast. I have never felt before the way I felt that day. I was inconsolably crying, paralysed with terror, and curled up on the sofa. I called in sick to work and spent the best part of the entire day on the phone to my parents who flew out the next day to be with me. All of this was entirely alien to my husband. He knew I worked in mental health but I guess I never realised that he totally didn’t understand what I did and what mental health looks like. He had no idea what was going on with me and had to learn how to support me.

I am really lucky to have found a supportive and really competent GP when it comes to managing mental health. I wanted to be put on a course of medication as I know that medication is a key part of the treatment equation and the SSRIs I am on have helped tremendously. My GP also gave me a temporary course of benzodiazepine very closely monitored by her to help me with the initial stage of going to work, coping with the anxiety and helping me sleep initially.

All in all, this was a really acute depressive/anxious episode and I did go back to work the following week with a LOT of positive self-talk, support from husband and family, and a chill pill. My recovery was gradual and I guess I realised that we are all vulnerable at one time or another. My parents have both experienced anxiety and depression over their lives and I know that having a depressive episode makes it more likely that we will experience further episodes.

Recovery means making your mind your priority and this is what I’ve tried to do. I have regular follow-ups with the GP every few weeks as I’m still taking medication. I am concerned about how coming off the medication might affect me but I have a good relationship with my doctor and trust that she will manage that process with me in the next few months. When I’m feeling anxious and restless I know I need to up my exercise to channel my adrenaline elsewhere. I try to facetime friends and family more often and say what I’m feeling more. My friends have been so supportive and didn’t judge or change their behaviour towards me when I told them- I found it really hard to tell them though. Having a good night’s sleep helps too- going to bed and waking up at regular times. I have also found Acceptance and Commitment Therapy (ACT) self- help reading to be extremely helpful too and highly recommend “The Happiness Trap” by Russ Harris- a refreshingly easy way of managing difficult emotions and learning to live with them.

The biggest piece of advice I can give anyone who is struggling with negative thoughts, depression, anxiety, stress, is to tell the people closest to you what helps you. Sometimes it’s the fact that our family’s, partners, friends don’t know what helps or what to say which causes more stress or potential conflict. Tell them what you would like them to do or say to you when you are feeling a certain way. I told my husband that every time I start to feel anxious, inadequate and catastrophising about my work, to remind me of how much enjoyment I have had at work and the positive things I say when I get home from work.

I don’t believe that a cardiologist should have experienced a heart attack to make them more capable of treating a patient effectively, but as a Mental Health Professional, I do have that bit more compassion and understanding of the vulnerability that we all have, no matter which chair you are sitting in.

 

 

Guest Post: The Efficacy of Online Cognitive Behavioural Therapy- CBT by Dr Stacey Leibowitz- Levy

We are delighted to have Dr Stacey Leibowitz-Levy, psychologist writing about Cognitive Behavioural Therapy for us. As with any therapeutic practice, it is very much individual as to whether it will work for you and CBT will not work for everyone- but has been proven to work for many. Here Dr Leibowitz-Levy explains how it can work online.                        

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Online counselling is a growing field with more and more people turning to the internet to seek out counselling help. Counselling services offered online incorporate the range of therapeutic approaches that have been developed within the field of psychology. Approaches to understanding mental ill health and treatment include therapeutic approaches such as logo therapy, psychodynamic therapy, systemic therapy, psychodynamic therapy and Cognitive Behavioral Therapy (CBT). How do these therapeutic modalities translate to the online environment? This article will address the compatibility of CBT in particular as an online counselling approach.

CBT is a widely-utilised mode of therapy that focuses on an awareness of the relationship between thoughts, feelings and behaviour. The aim of CBT is to address difficulties through modifying distorted thoughts, unhelpful behaviour and unpleasant emotions. In order to achieve this end, the client works collaboratively with the therapist in building awareness and understanding of his/her condition, and an accompanying skill set for evaluating and changing distorted beliefs (as well as modifying dysfunctional behavior). The therapist develops clear objectives and a treatment plan that requires active participation from the client during sessions, and follows through on homework assignments between sessions.

This form of therapy is characterized by a structured, time limited and outcome focused approach to managing mental health challenges. Often CBT is focused on a specific issue such as anxiety or managing depressive thoughts and, as such, many CBT interventions are available in a protocol format. CBT offers a delineated and clearly defined intervention that is largely directed by a clearly defined process and structure. This is in contrast to many other therapeutic approaches that have less defined parameters and take their cue on a session to session basis from the client.

The format and approach of CBT lends itself to an online format in that the structure and process are not only defined and constrained by the relationship between therapist and client but are also defined by a clearly delineated therapeutic procedure. This procedure offers a framework within which to deliver support which can easily be translated to an online process. CBT follows a set format. It is driven by the imperative of building an understanding of the issues the client is experiencing and imparting a certain skill set to assist the client in managing his/her mental health issues. CBT is thus based on specific content and has a strong psychoeducational aspect, which means that delivery online can be located in tangible and clear cut content and outcomes for the client.

This also allows for versatility in the delivery of CBT online. While face to face time with a therapist may be desirable for some clients, the option of online delivery of psychoeducational as well as skills based elements in other formats also works well. For instance, the psychoeducational aspect could be communicated very effectively through a video delivery. CBT lends itself to the format of online courses where clients are guided through a process of identifying and understanding their particular issues and developing the skills to manage them. Interspersing this with face to face time or the opportunity to clarify or ask questions in a chat or e-mail format makes for a very effective online intervention.

While many of the issues addressed in CBT are personal to the client, the possibility of locating these issues within a more general format is very much part of the CBT approach. There is a set way of getting information from, and accessing and understanding the client’s experience, with the client having to act on this information between sessions. This more “scientific” process also makes for an approach that lends itself to an online format.

The efficacy of CBT as an online intervention is borne out by the number of sites specifically offering online CBT in a variety of formats (for some examples, see here and here). The online availability of this well researched and well-verified approach to managing mental health problems offers increased affordability, accessibility and greater choice for mental health consumers.

Dr. Stacey Leibowitz-Levy is a highly-experienced psychologist with a Master’s Degree in Clinical Psychology and a PhD in the area of stress and its relation to goals and emotion. Dr. Stacey has wide ranging skills and expertise in the areas of trauma, complex trauma, anxiety, stress and adjustment issues. Stacey enjoys spending time with her husband and children, being outdoors and doing yoga.

Therapy Tales Part One.

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My therapy journey began at just 15 years old- when I went to see the school counsellor for talking therapy due to suffering my first anxious and depressive episode (before I was diagnosed as bipolar).

Since then- 13 years later, I have tried many different kinds of therapies to help heal me from my anxiety disorder and help manage my bipolar disorder. Therapy still has a stigma, which is wrong,- but it is vital to the healing and recovery of mental illness and general healing from stressful life events eg deaths, divorce, moving house, illness.

I have done many forms of therapy, starting off with talking therapies- where you talk to your therapist about whats going on in your life (and sometimes they psychoanalyse in order to help you). I then did 3 lots of Cognitive Behavioural therapy (CBT). This is where you unpack your negative thoughts and assumptions that cause your illness in thought records, where you learn to challenge thoughts and change behaviour. However, for me, CBT was frustrating. I felt like I couldn’t fully apply it and it didn’t click with my brain.

I felt that the anxiety and panic I was dealing with was very much in the subconscious- and so the CBT could not eradicate the emotional, deep response that had formed within me to certain situations. It was then I began to realise the power of exposure therapy- which is essentially, exposing yourself to your feared situation slowly, with support. The more I went out, the more people I saw and the more I did, the anxiety began to lessen. It boosted my self esteem too to know I could overcome my fears. It is something that has to be practised and you have to be kind to yourself too and in the right head space for it to work,.

Of course, therapy works in conjunction with medications and it is also vital to make sure you like your therapist and have a good relationship with them. If you dread seeing them and you aren’t getting much from it, they are likely to be the wrong therapist for you.

I have done many other therapies: art therapy (which I loved and recommend hugely if you enjoy it), meditation and deep breathing (which I still do and which really helps my anxiety) and of course the unique therapy that friends and family bring. There are more therapies out there including ACT and its always worth googling therapies.

Ultimately, don’t be too scared about sharing with a therapist. They are trained professionals, have seen it before and they are there to support you. It is also very much trial and error. Even though CBT wasn’t for me, I found other therapies which have worked.

Just be aware that NHS therapy waiting lists are months long, so if you have the money to get private care, do.

I have worked with both psychologists, psychotherapists, occupational therapists (during a period of group therapy) and of course psychiatrists in order to keep well. It is very much a collaborative effort and now I am much better, I can deal with it with my support network (with my psychiatrist in the background)

I hope you find the right course of therapy for you and know you can heal from whatever stresses you are dealing with.