Intensive Outpatient Services

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Intensive Outpatient Services

Intensive Outpatient Services

Extra time and attention, home visits, more intensive services, and greater coordination of care across multiple providers are cornerstones of our intensive outpatient services.  If you or a family member needs a higher level of service, we consult with you (or with parents if the person in therapy is a minor) and tailor your treatment plan to reflect this increased need.

Intensive outpatient services are offered in each of our areas of expertise and may include:

  • Exposure therapy (out of office) several times per week for 90 minutes or more to address symptoms of Obsessive-Compulsive Disorder (OCD), phobias, panic disorder, and other anxiety disorders.
  • School-based or home-based observation and intervention to address school refusal, to resolve parenting challenges, to model intervention skills, or to assist in organization and executive functioning.
  • Attendance by your provider at a school meeting to decide accommodations, meet with school staff, or complete school-based observations.

Your provider will guide you, explaining the likely benefits of increasing frequency or intensity of care.

During the regular course of therapy, your provider is constantly assessing the benefits of treatment, measuring progress, and evaluating outcomes.   If he or she notes that a better treatment response would likely include intensive care, your provider will recommend specific, evidence-based advantages to increasing the intensity and frequency of treatment.  Your provider may recommend either an intensive outpatient program or residential care as options.  If residential care is needed, we will assist you in connecting with some of the best options in the country.

For more information, please ask your provider about intensive outpatient services.

Intensive Outpatient Program for OCD

The intensive treatment program for OCD is a central part of our suite of intensive services.  The program includes multiple providers and focuses on Exposure and Response Prevention (ERP), the gold standard for treating OCD.  ERP is the most effective therapeutic treatment for OCD.  It focuses on working with the individual gradually to face his or her “obsessions” (the “O” part of OCD, or the stimuli that cause fear or discomfort) without doing a “compulsion” (the “C” part of OCD, or the ritual or response that brings only short-term relief and ultimately worsens the disorder).   Research suggests that ERP is most effective when it is practiced daily, most days of the week, over several months at a time.

When symptoms of OCD cause moderate to severe distress or disruption in daily life activities (for example, absence from school or work, isolation, interference with relationships), intensive treatment of OCD is recommended.  The primary benefit of participating in intensive treatment for OCD, rather than in traditional, once-weekly appointments, is a more rapid response to treatment and a faster return to usual activities.

The intensive outpatient treatment program for OCD includes a thorough evaluation and planning for ERP.  Intensive treatment involves multiple sessions per week (3-5 sessions per week, depending on severity of symptoms) for a longer duration than typical appointments (90-120 minutes rather than 45-60 minutes).  The specific frequency and duration of treatment sessions will depend on information gathered in the initial intake (including severity of symptoms, willingness to engage in treatment, time to engage in treatment, and financial factors).  A team (2-4 providers) coordinates and carries out all activities, including team meetings to assess progress.  As OCD symptoms are reduced, the frequency of visits is reduced accordingly.

For many individuals with moderate to severe OCD symptoms, treatment with medication can be helpful to reduce anxiety symptoms or co-occurring symptoms, such as depressed mood or insomnia, to facilitate participation in ERP.   The intensive treatment program includes psychiatric assessment and medication management through collaboration with Park Psychiatry in McLean, VA.   During the initial meeting, symptoms and treatment history will be reviewed in order to rule out medical issues that could be affecting daily function (such as anxiety due to thyroid disorder, depression due to anemia, or fatigue associated with vitamin deficiency).  Treatment of medical issues occurs through collaboration with the primary care physician or pediatrician.

Because OCD affects the entire family, intensive treatment also involves parents of children/teenagers with OCD and spouses/significant others of adults with OCD.  For children/teenagers with OCD, a team member will meet with parents at least once weekly for a parent session to communicate progress, next steps for treatment, and parenting strategies, such as techniques for reducing accommodation of OCD.   Parents will also be expected to be present at treatment appointments in order to be aware of what the child/teenager is working on during sessions and what he/she is expected to work on outside of sessions.

We also offer group options for parents, spouses, or other family members.  Group options are offered periodically throughout the year and may include the following:

  • Orientation group for new patients
  • Psychoeducation
  • Coping and relaxation techniques, including mindfulness training
  • Medication education
  • Parenting
  • Dialectical Behavior Therapy (DBT)
  • Young adult support group 

In addition to helping individuals with OCD, the intensive outpatient program may be appropriate for those with moderate to severe depression, social anxiety, or panic disorder.   This level of intensive treatment offers the same benefits as in OCD, including more rapid reduction in symptoms, faster return to usual activities, and more support for the individual and family members.

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