Breaking the Rules: A Clinician's Guide to Treating OCD

35 Episodes

By: Dr Celin Gelgec and Dr Victoria Miller

Breaking the Rules is a show for mental health professionals designed to help you build confidence in treating Obsessive Compulsive Disorder (OCD). Effective treatment of OCD requires commitment, creativity and the recognition that things can sometimes get a little … messy. And on the show, you’ll hear from a range of leading professionals and learn everything there is to know about OCD and other related mental health concerns. This podcast is brought to you by Melbourne Wellbeing Group, a psychology practice based in Melbourne with a special focus on treating OCD.

Using deep brain stimulation for treatment-resistant OCD

Dr Luca Cocchi is a Group Leader and Associate Professor at QIMR Berghofer, who is currently working on ways to improve TMS for its usage in OCD treatment. Dr Philip Mosley is a Psychiatrist and Clinician-Scientist at QIMR Berghofer, where he is currently researching DBS for treatment-refractory OCD. 

In this episode, Phillip explains deep brain stimulation (or DBS) and how it's being used to treat severe and treatment-resistant OCD. Phillip and Luca also discuss the outcomes of recent clinical trials and explain how accessible these treatments currently are for Australians. 

This episode is part two of...

The neuroscience behind OCD

Dr Luca Cocchi is a Group Leader and Associate Professor at QIMR Berghofer, where he is currently working on ways to improve TMS for its usage in OCD treatment. Dr Philip Mosley is a Psychiatrist and Clinician-Scientist at QIMR Berghofer, who is currently researching DBS for treatment-refractory OCD.

In this episode, Luca and Phillip explain the neuroscience behind OCD, as well as what treatment-resistant OCD means and why it happens. Plus, Luca breaks down the exciting possibilities of transcranial magnetic stimulation (or TMS) for OCD.

This episode is part one of our two-part chat with...

How to implement mindfulness in ERP

Welcome back to another skills episode! Today, we're covering something you may have heard mentioned a few times in our previous episodes: meditation. Mindfulness-based strategies can be incredibly useful for clients and clinicians alike, and there are many ways they can be helpful when integrated with ERP.

In this episode, we'll explain why mindfulness is so important, and share how you can best teach it to your clients. You'll also hear us discuss why it's important for all of us to learn to feel our feelings, and to understand the difference between noticing thoughts and dismissing them...

Navigating nerves as an early-career psychologist

Hannah Gersh is a Psychologist and Clinical Registrar at the Melbourne Wellbeing Group. As an early-career psychologist, Hannah understands how nerve-wracking it can be to start in the industry, and is here to share her experiences to help ease the nerves of any other early-career psychologist. 

In this episode, Hannah shares how she found her way into working with OCD, as well as how she deals with nerves and feelings of inadequacy. She'll explain what she's found most useful for her development as an early-career psychologist, before sharing some advice for clinicians looking to get into the O...

Creating ERP tasks for Pure O and POCD

Welcome back to our deep dive into creating ERP tasks, where we're continuing to explore the ways you can get creative in treatment, regardless of the presentation or the subtype.

In this episode, we're exploring different ways to create ERP tasks in the context of pure OCD, and paedophilic OCD. We'll share the ways to help your clients interrupt mental compulsions, as well as how to create safe and appropriate tasks for managing paedophilic intrusive thoughts. Plus, we'll share how you can take the learnings from these subtypes, and apply them to creating ERP tasks in any...

How to create ERP tasks

Welcome back to another skills episode! This week, we're following on from our previous skills episode, "What is ERP?", with an episode on how to create ERP tasks. We'll be exploring all the ways you can break the rules and get creative with ERP, whilst still remaining evidence based in treatment.

In this episode, we'll explore how to design exposure tasks for OCD, regardless of the subtype. We'll also share how important it is to stay collaborative, creative, and courageous — regardless of whether you're a client or clinician.

This episode is part one of our tw...

What your family member with OCD needs from you

Penny Moodie and Rosie Frankish are the Co-founders of the So OCD website, a resource built to provide local support for Australians with OCD. Penny Moodie is an OCD advocate, with a background in media and communications, who is currently studying for a social work degree whilst writing a book about OCD. Rosie Frankish has a background in psychology and currently works in the community mental health sector, developing and delivering specialist mental health and homelessness programs across Victoria.

In this episode, Penny and Rosie discuss all things family support, including what they believe family members need...

What it's like to live with OCD

Penny Moodie and Rosie Frankish are the Co-founders of So OCD, a website resource built to provide local support for Australians with OCD. Penny Moodie is an OCD advocate, with a background in media and communications, who is currently writing a book about OCD whilst studying for a social work degree. Rosie Frankish has a background in psychology and currently works in the community mental health sector, where she is involved in the development and delivery of specialist mental health and homelessness programs across Victoria.

In this episode, Penny and Rosie share their stories of being diagnosed...

How to support a loved one in treatment

Navigating the process of supporting loved ones in treatment can feel like walking through a minefield. It's easy to question if it's appropriate to involve yourself in the treatment process, where the boundaries lie, and how to even begin. These questions can feel overwhelming and often lead to us doing nothing at all.

In this skills episode, we discuss how clinicians can expand their treatment plans to include a client's family and friends, while still maintaining appropriate boundaries. We'll also emphasise the importance of accessing knowledge, practising self-care, communicating, and holding space for grief for those who...

How to use the inhibitory learning model in clinical practice

Dr Jonathan Abramowitz is a clinical psychologist, author, and Professor for the Department of Psychology and Neuroscience at the University of North Carolina in America. With over 25 years of experience, Jon is recognised internationally as a leading authority on the treatment and study of OCD and is dedicated to researching and publishing his findings on OCD treatment and passing on his knowledge to the next generation of clinical psychology students. 

In today's episode, Jon explains how to integrate the inhibitory learning model into clinical practice and the importance of maintaining consistency in that process. He then shares h...

The evolution of the inhibitory learning model

Dr Jonathan Abramowitz is a world-renowned clinical psychologist and a Professor in the Department of Psychology and Neuroscience at the University of North Carolina. Jon has over 25 years of experience working in the treatment of OCD and related disorders and has contributed to hundreds of scientific publications in that time. He also trains clinical psychology students and is the author of several books and book chapters. 

In today's episode, Jon explains how he came to be involved with OCD treatment and research in the first place. He shares his insights on the evolution of the inhibitory learning m...

Adapting ERP for group therapy

It's easy to get bogged down in the options that are available when deciding on treatment options for clients. Treatment for OCD can include inpatient treatment, one-on-one treatment, group therapy, and anything in between. 

In this episode, we're going to do a deep dive into group therapy, and how to adapt ERP to work in a group therapy setting (spoiler alert: it's easier than you think). We'll explore the structure of a group therapy session, and how to manage challenges such as cost and time limitations. Plus, we'll discuss the power of group therapy, and how beneficial i...

The challenges in embracing uncertainty

Dr Jonathan Grayson is a Licensed Psychologist, Author, and Director of the Grayson Center in LA and the Adjunct Clinical Assistant Professor of Psychiatry and the Behavioral Sciences at the University of Southern California. Jonathan has specialised in OCD treatment for over 40 years and even authored an award-winning book on the topic, 'Freedom from Obsessive Compulsive Disorder: a Personalised Recovery Program for Living with Uncertainty.'

In this episode, Jonathan continues explaining what it's like to live in genuine uncertainty and explores the challenges both clients and clinicians can face when fully embracing uncertainty. Plus, he shares...

Uncertainty and OCD

Dr Jonathan Grayson is the Director of the Grayson Center in LA as well as the Adjunct Clinical Assistant Professor of Psychiatry and Behavioral Sciences at the University of California. Jonathan has over 40 years of experience in the treatment of OCD and was the recipient of a Lifetime Achievement Award from the International OCD Foundation.

In today's episode, Jonathan explores the concept of uncertainty and how to get better without knowing all the answers. He then goes on to share valuable insights into how to discuss uncertainty with clients and even demonstrates how it works in treatment. 

Utilising ERP in group therapy

Dr Clair Lawson is a clinical psychologist and the Director of her group private practice, Lawson Clinical Psychology, in Perth, Western Australia. She has over 21 years of experience working as a clinical psychologist in government and private practice settings and has spent much of this time treating OCD. Clair is also a training supervisor for clinical psychology students at the University of Western Australia and a mentor for allied health businesses looking to increase their impact.

In today's episode, Clair shares her perspective on what ERP is like in a group therapy setting and the ways you...

The trajectory of OCD research and treatment

Paul Salkovskis is a Professor from the Oxford University in the UK. Paul has worked as a clinical psychologist since 1979 and as a researcher interested in the treatment of anxiety disorders, including OCD, panic disorder, agoraphobia, and health anxiety. He's also on the editorial board for several psychology journals and is the current president of the British Association for Behavioural and Cognitive Psychotherapies. 

In today's episode, Paul explores the current research trajectory into OCD and treatment options. Paul shares his knowledge from years of working with OCD and his ideas on how betrayal functions in OCD. He f...

Familial influences on anxiety and OCD

Dr Eli Lebowitz is an Associate Professor from Yale University who studies and treats childhood and adolescent anxiety. Eli is also the Program for Anxiety Disorders Director at the Yale Child Study Centre. His research focuses on the development, neurobiology, and treatment of anxiety, but his passion lies in exploring cross-generational and family influences on anxiety and related disorders.

In today's episode, Eli shares some ways clinicians can support parents if their children are diagnosed with OCD. He also details some of the reasons we might be getting it wrong in supporting families and explains how the...

How to deal with meltdowns

Emily Crawford is an Educational and Development Psychologist with over 20 years of experience supporting adults, children, adolescents, and their families with various mental health issues (including OCD). She is passionate about engaging parents in the support of their children and tailoring approaches to support her client's individual needs. Emily is also a 'Tuning in to Kids' facilitator and a mother of four young children herself.

In today's episode, Emily breaks down all things meltdowns. She shares why kids have meltdowns, what parents can do when their child is melting down, and why it's so hard for parents...

Autism and OCD: Similarities, differences, and treating clients with both

Dr Marie Karakis is an Educational and Developmental Psychologist who works closely with neurodiverse young people, including those with autism, ADHD, and OCD. She is also the Director of Young Minds Psychology, a private practice that provides assessment, intervention, treatment, and school consultations.

In today's episode, Marie shares her insights into the similarities and differences between autism and OCD in young people and what to consider when treating OCD in neurodiverse clients. Plus, Marie details some of the things she found most useful in her practice, such as the importance of forming client connections.


The intersection of OCD and anxiety

Dr Emily O'Leary is an experienced Clinical Psychologist passionate about treating OCD and the Managing Director of three clinical psychology practices and one psychiatry practice. She also manages a consulting business that provides training and supervision to other psychologists in her areas of interest. 

Emily is committed to raising awareness of the complexity of disorders like OCD and anxiety, which she does via lectures, workshops, and online and print media in Australia and worldwide. In today's episode, Emily shares her knowledge of OCD and anxiety and how they present in clients that deal with both. She also d...

OCD and body-focused repetitive behaviours

Tanya Arabatzoudis is a Clinical Psychologist with a special interest in body-focused repetitive behaviours (BFRBs), specifically trichotillomania. She spent her postgraduate studies exploring how emotion regulation and trichotillomania were linked and now works with patients with OCD and BFRBs. 

In this episode, Tanya explains BFRBs and the current limitations on research into these behaviours. Tanya also breaks down how to use the SCAMP model in your practice and reminds us all how important it is to be able to 'go with the flow'.



How to include fun and families in a young person's treatment

Catherine McGrath is a Senior Psychologist at the Melbourne Wellbeing Group. She has over 15 years of experience working with young people and families who are dealing with all sorts of mental health concerns, including OCD.

In today's episode, Catherine shares her tips on when to include family in the treatment of a young person before detailing her experience working with younger clients with OCD. She then discusses ideas for how to have fun in therapy with games like 'Spot It'.



What is ERP for OCD treatment?

We've been leading up to this moment for the past few skills episodes. We have referenced ERP and talked about it, but what is it? 

So in this episode, we'll finally answer that question! We're also going to answer other frequently asked questions about ERP, such as do we need to do a hierarchy, aren't we just teaching distraction, and how does ERP work with the different subtypes of OCD? 



This show is produced in collaboration with Wavelength Creative. Vis...

Mental health in schools

Brydie Huggins is a school psychologist with over 15 years of experience working with young people in school settings. She's passionate about involving parents in the treatment process and delivering programs such as Tuning in to Kids, which helps teach an emotion coaching approach to parenting. 

In today's episode, Brydie explains the impact that schools can have on a young person's mental health and the importance of sound systems to support them in this environment. Plus, she shares an insight into the importance of setting boundaries as a practitioner to ensure you deliver the best support for your c...

Treatment options for OCD

OCD is a complex disorder, and it's easy to feel stuck when it comes to treatment options, no matter the client's age. So what are the treatment options, and when should we use them?

In today's episode, we're talking through the various types of treatment available for OCD, from psychological therapy to deep brain stimulation. Then, we'll share our insights into how you can get messy with treatment whilst remaining evidence-based in your work.



This show is produced in c...

The common pitfalls of treating OCD

Dr Michael Twohig is a well-renowned professor of psychology at Utah State University. His research includes exploration of acceptance and commitment therapy in OCD treatment, and he has published over 200 scholarly works and seven books. 

In today's episode, Michael explains the most common problems when treating OCD. He also talks us through his two most recent books, ACT in Steps, co-authored with Dr Michael Levin and Dr Clarissa Ong, and The Anxious Perfectionist, co-authored with Dr Clarissa Ong.

This episode is part two of our conversation with Michael. Check out our last episode for the f...

How to utilise acceptance and commitment therapy in treatment

Dr Michael Twohig is a professor of psychology at Utah State University, where he teaches and studies the use of acceptance and commitment therapy in OCD treatment. He co-runs the Acceptance and Commitment Therapy Research Group and has published over 200 scholarly works, with funding from sources such as the National Institute of Mental Health and the I-OCD-F.

In today's episode, Michael talks us through his research on acceptance and commitment therapy and its potential uses for OCD treatment in conjunction with ERP before sharing his insight into the importance of flexibility as a healthcare practitioner. 


The subtype we haven't mentioned yet

Today, we're back with another Skills episode, covering the OCD subtype we haven't discussed yet: Pure O. We'll be discussing where the term came from, why we're so confused by it, and what the research tells us about this unique subtype.

In this episode, you'll hear us exploring and thinking out loud about Pure O. We talk about where the idea of Pure O came from, what it looks like in session, and how it can create confusion for clinicians and clients alike if it's misunderstood.


Connect: h...

What modern medicine is missing in treating the mental health crisis

Dr Johanna Lynch is a Senior Lecturer at The University of Queensland, as well as a General Practitioner. She presents to audiences internationally and across Australia, and conducts professional case consultation and coaching for GPs and multidisciplinary clinicians.

In this episode, Johanna shares more about how the mind and body connection to healing is the missing link in most modern medicine. You'll be inspired by her wisdom and her carefully developed approach to distress that makes sure not to dismiss or ignore pain. Plus, an insight into her book, all about whole-person care.

This episode...

The importance of whole-person care

Dr Johanna Lynch is a General Practitioner and Senior Lecturer at the University of Queensland. Alongside presenting to audiences across the globe, Johanna works closely with GPs and students, teaching whole-person care and mental health skills. 

In today's episode, Johanna shares how she came to work in the mental health industry and be a champion for whole-person care. She introduces us to the importance of listening in the healing process and details some of her research on using whole-person care to help create a sense of safety.

This episode is part one of our two-part c...

Subtypes of OCD

In today's episode, we're exploring everything you need to know about themes and subtypes of OCD, and asking the critical question: do subtypes of OCD matter? 

We talk about the different kinds of subtypes and how these may change throughout someone's life. We'll also explore when it might be helpful to categorise OCD subtypes with a client and give you a handy way of conceptualising themes of OCD using the analogy of form versus function. 



This show is produced in...

How psychologists and psychiatrists can work together

Dr Claire Cody is a Psychiatrist and the director at The Village Clinic, where she looks after infants, children and teens, alongside consulting for various hospitals around Melbourne. Claire has a passion for working holistically with young people and families and hearing their stories so they can work together towards recovery.

In this episode, Claire shares her thoughts on the role psychiatry plays in treating mental health in young people and discusses best practices in establishing a multidisciplinary team that best supports families, before getting personal by sharing some of her own intrusive thoughts. 



How do we assess symptoms of OCD?

Today, we dive into the all important question: How do we assess symptoms of OCD?

Assessment of OCD doesn't always happen in one session - sometimes you need to work with someone for a long time before they reveal a part of themselves that then allows you to make a diagnosis. 

And so on today's episode, we discuss OCD's symptoms according to the DSM-5 Diagnostic Criteria, and the various types of assessments you can use when screening for OCD. And we also explore how to determine if someone’s thoughts are egosyntonic or egodystonic (and wha...

The role of psychiatry and medication in the treatment of OCD

Dr Scott Blair-West is a consultant psychiatrist and the Co-founder and Medical Director of the OCD program at The Melbourne Clinic. Scott also works in private practice, as well as pro-bono for the Asylum Seeker Resource Centre. And … he also provides training on anxiety disorder management and CBT to trainees, psychologists and psychiatrists.

In this episode, you’ll hear about the role of psychiatry and medication in the treatment of OCD, the benefits of inpatient admissions and some of the interesting things Scott has learned during his career including… (wait for it!) his belief that providing reassurance to cli...

What is OCD?

Welcome to our very first episode! We’re so excited to be kicking off our podcast today by explaining a common question we get: What is OCD? We’ll be discussing everything from what obsessions and compulsions look like, to what happens in the brain when someone has OCD.

In this episode, you’ll learn about the complexities of OCD in a way that will help you and your clients understand it better. We also dive into the mechanisms behind how compulsive behaviours occur and why Exposure and Response Prevention (ERP) therapy is so effective in helping your c...