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Case Study Examples On Ocd

My Experiences with OCD: A Case Study

Adele (24) has been experiencing OCD symptoms for around 5 years now, since she was 19 years old. Her symptoms revolve around OCD obsessions with hygiene and cleanliness. Here is her take on how she is affected by her OCD symptoms.

Obsessions and Compulsions

Like OCD sufferers in general, her obsession with cleaning has taken over her life. “I clean even if it looks tidy and it needs to smell like Dettol or bleach. It has driven me mental though because I can’t control the urge, and there are days when I am tired or have things to do but am late due to cleaning. I can clean for hours and there have been days when I’ve got up at 7 in the morning and not stopped until midnight. As I am particular and specific, thankfully it’s only my own house that I’m like this in - although in my head, I’m thinking ‘I’d love to clean that’ when I’m elsewhere. I had a job cleaning high class apartments and loved making them look like new. I gained big satisfaction but sometimes if I ran out of time and it wasn’t done to my high standards, I would be upset about it.”

How Others React

OCD can have a big impact on relationships and Adele has found that other people haven’t been that understanding about her condition. “Everything has a place but my ex would leave his stuff in other places and my blood would boil. I’d even cry as it felt like I had so much work to do. My friends think I’m a control freak and don’t understand it.”

Knowing other OCD sufferers also helps Adele to feel that she’s not alone with her OCD symptoms. “I know someone who also has OCD, although theirs is more compulsive than obsessive. They give me support and it does help that someone knows exactly what I’m going through and how to take me.”

Treatment

Adele has tried both therapy and medication in her bid to overcome her OCD symptoms. “The therapy lasted for about a year but I think it made me more depressed as I had to talk about things that may have been an underlying problem. In one treatment session, the therapist actually licked the table and the very thought of it makes me cringe. These were ways of trying to make me tackle the OCD but in reality, it drove me deeper into cleaning! The medication I think is false hope as the OCD symptoms are always there. I’m still on the medication but I still suffer with OCD, although I do feel a little more in control.”

Self-help Measures

Because her experiences with OCD treatment and medication haven’t been as successful as she had hoped, Adele has turned to self-help measures to help her deal with her OCD symptoms more effectively. “I have helped myself as well by not giving into my pressures. It is hard though and the OCD wins more than I do.”

The Current Situation

While Adele has tried various ways to tackle her OCD symptoms, she has not yet been able to overcome them. She is due to move house soon and is not sure whether her OCD symptoms will intensify with the added stress and mess. She plans to try some further self-help techniques in the future and perhaps more therapy too.

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OBSESSIVE COMPULSIVE DISORDER

Background History

Paul is a 40 year old man diagnosed with Obsessive Compulsive Disorder. He has always lived with his parents and remains in the family home. He had maintained an office job for over 15 years but was reliant on his 75 year old mother to drive him to and from work. He experienced intrusive thoughts that his actions have caused, or will cause, harm to others and constantly rechecked his steps or actions.

Reason For Referral

Paul was referred for occupational therapy by his Consultant Psychiatrist due to concerns regarding his over-reliance on his ageing parents, his limited activities in daily living and a decrease in personal hygiene. Paul's safety behaviours enabled him to operate within his office at work and his bedroom at home but he avoided any other activities for fear he may cause someone harm.

Occupational Therapy Assessment

An initial Occupational Therapy Assessment was conducted which drew on a number of occupational therapy models and treatment strategies including the Model of Human Occupation, the Assessment of Motor and Process Skills (AMPS) and a more informal one to one interview.

The assessment identified that:-

  • Paul's OCD and intrusive thoughts were having a significant impact on his processing skills – his process scores on the AMPS were below the level expected for someone of his age;
  • Paul’s personal care had deteriorated as his intrusive thoughts impacted on his ability to get up and ready for work in the morning - he would often just get dressed without washing as he could do this whilst remaining in his room;
  • Paul had never used public transport having always been reliant on his mother for transport;
  • If Paul was to repeat a task the intrusive thoughts would lesson over time.

Occupational Therapy Treatment Plan

Paul participated in an Occupational Therapy Programme consisting of 24 sessions over a six month period which focussed on:-

  • Enabling Paul to develop a person centred prompt list in the morning to help him improve his levels of personal care;
  • Developing a graded exposure plan focussing on increasing his confidence in public places enabling him to travel to work on public transport;
  • Identifying strategies to enable Paul to extend the period of time he was able to tolerate, and not act on, his intrusive thoughts/urge to check.

Outcome

On completion of his Occupational Therapy programme, Paul was able to:-

  • Improve his levels of self care leading to a positive impact on his relationship with colleagues at work;
  • Undertake a graded activity plan with the support of his Occupational Therapist enabling him to use public transport initially with his therapist and then independently;
  • Increase his confidence interacting with others and spending more time outside his room at home and being able to play and interact with his nieces.

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