Treating the Severe OCD Client
by Reid Wilson
Severe OCD can seem hopelessly intractable, especially when a client has invested significant time in past therapy. Here, anxiety disorder expert Reid Wilson employs a variation of cognitive and strategic methods in two live sessions, demonstrating his paradoxical approach to tackling obsessive thinking.

Part of the 6-video series: Strategic Treatment of Anxiety Disorders
Bob, a young, fit personal trainer exhibits pervasive “repeater” behaviors that lead him to tell Wilson, “I want my mind back.” Obsessed with the worry that his debilitating anxiety will remain with him until he takes corrective action, he spends much of his time repeating getting dressed or preparing for bed. Trying to avoid anything that triggers his fear of getting stuck in escalating anxiety, Bob is losing sleep, showing up late to the work he loves, and lacking the mental space he needs to build a successful life. What’s more, months of previous exposure-based therapy has barely helped him, leaving Bob without the tools to manage his daily life.

In two sessions with Bob, Wilson demonstrates the core concepts underlying his distinctive approach to treating anxiety disorders. With compassion, clarity, and aggressive analogies that leverage Bob’s courageous temperament, he passionately encourages him to rise above the content of his obsessive thoughts and practice moving towards that which he fears, supporting him in learning to tolerate uncertainty. Calling on Bob’s innate fighting spirit, he helps him “bring it on”—and dramatically alter his relationship to anxiety.

If you’re looking for a fresh understanding of OCD and effective ways to treat its most unyielding aspects, you’ll find it in Wilson’s engaging, lively approach.

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What therapists are saying…

"Dr. Wilson does a masterful job working creatively with a client suffering from persistent, treatment-resistant OCD. By adapting a cognitive approach to the client’s unique strengths and attitude, Dr. Wilson helps him to develop an aggressive, paradoxical stance against the OCD, which proves to be remarkably effective in only two sessions. A beautiful demonstration of how tailoring treatments to the individual client can make all the difference."

 -- Victoria Lemle Beckner, PhD, Clinical Faculty, University of California San Francisco; Author, Conquering Post-Traumatic Stress Disorder
"An excellent teaching tool for both new and experienced therapists. Wilson skillfully leads the clinician step by step through his unique approach to OCD, an invaluable alternative to traditional ERP treatment. I highly recommended it to anyone supporting clients with OCD."

-- Fugen Neziroglu, PhD, ABPP, Clinical Director of the Bio-Behavioral Institute, Great Neck, NY; Author, Overcoming Body Dysmorphic Disorder
In Depth
CE Test
Months of previous exposure-based therapy hasn’t given Bob much relief; he comes to Wilson claiming that now is his worst time with OCD, which he’s suffered from since age 10. Intelligent and physically fit yet consumed with “repeater” behavior that detracts from his life goals, Bob lacks real-world tools to manage his anxiety, and lacks much hope for change.

Wilson’s compassionate but firm approach takes the view that “If [clients] don’t risk the feared consequence, they can’t get better.” Over two sessions, Wilson leverages Bob’s innate fighting spirit to support him in “moving toward” the anxiety that drives his compulsive behaviors, helping him more fully engage with his discomfort and fundamentally change his circumstances.

By watching this video, you will:
  • Learn the core concepts of Wilson’s approach to treating the severe OCD client.
  • Understand how to conduct a highly focused assessment.
  • Identify tools for helping clients increase their tolerance of uncertainty and discomfort.

Length of video: 02:42:10

Number of Discs: 1

English subtitles available on: Stream

This DVD plays in All Regions

Individual ISBN-10 #: 1-60124-360-X

Group ISBN-10 #: 1-60124-361-8

R. Reid Wilson, PhD is a licensed psychologist who directs the Anxiety Disorders Treatment Center in Chapel Hill and Durham, North Carolina. He is also Clinical Associate Professor of Psychiatry at the University of North Carolina School of Medicine. Wilson specializes in the treatment of anxiety disorders and is the author of Don’t Panic: Taking Control of Anxiety Attacks (Harper Perennial, 1996), Facing Panic: Self-Help for People with Panic Attacks (Anxiety Disorders Association of America, 2003), and is co-author with Edna Foa of Stop Obsessing! How to Overcome Your Obsessions and Compulsions (Bantam, 2001). Wilson served on the Board of Directors of the Anxiety Disorders Association of America for twelve years and was Program Chair of the National Conferences on Anxiety Disorders from 1988-1991. In 2014 The Anxiety and Depression Association of America honored Wilson for a lifetime of service in treating anxiety disorders, awarding him the Jerilyn Ross Clinician Advocate Award at its annual conference in Chicago.

See all Reid Wilson videos.

CE credits: 6

Learning Objectives:

  • Learn the core concepts of Wilson’s approach to treating the severe OCD client.
  • Understand how to conduct a highly focused assessment.
  • Identify tools for helping clients increase their tolerance of uncertainty and discomfort.
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