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OCD INTENSIVE OUTPATIENT TREATMENT
 
Obsessive Compulsive Disorder (OCD) is part of the “Obsessive Compulsive (OC) Spectrum” of disorders that include Hypochondriasis, Body Dysmorphic Disorder, Trichotillomania, Tourette’s Syndrome and other neurobiological illnesses.  All appear to have in common elements of obsessive thinking and partially involuntary compulsive rituals or motor tic behaviors.  Genetically influenced disturbances or damage in different layers of the striatum and other associated areas of the brain have been implicated as causing or contributing to OC Spectrum (OCSPEC) Disorders.  This group of disorders are for the most part chronic and can be significantly debilitating and even result in mortality.  Recovery IS possible for most people and involves learning the practice of Exposure and Response Prevention (ERP) Behavior Therapy (and possibly use of serotonergic medication).   The process of recovery can often be very difficult and nearly impossible to accomplish alone.   
 
Finding qualified treatment providers, however, can be challenging.  Many counselors claim to be able to treat OCD but in fact do not have the specialized training needed.  Just as General Physicians are not equipped to do eye surgery, General Counselors are not equipped to do ERP.  Unfortunately trained counselors are few and far between and finding an ERP-trained counselor who ALSO has experienced OCD themselves (a huge asset in treatment) is very rare.  Also, for some individuals with OC disorders, seeking treatment may be problematic due to the difficulties of travel and the high fees charged by most OCD treatment centers and specialists. 
 
With these challenges in mind, The OCD Recovery Center of America now offers a traveling OCD Intensive Outpatient Housecall program in which we travel to the home location of the patient anywhere in the world (except where it is very cold – just kidding).  Using the mobile clinic model pioneered by other medical specialties (and most recently the Department Of Defense in treating traumatized soldiers) we are able to deliver three to fourteen days of highly intensive treatment to the patient in their home, office, school or community. 
 
Unless indicated otherwise, all specialized programs are conducted by Dr. Christian R. Komor, the founder of the OCD Recovery Center of America.  Dr. Komor is an American Psychological Association trained Licensed Clinical Psychologist on the National Register of Healthcare Providers.  Dr. Komor has treated hundreds of people with Obsessive Compulsive Spectrum Disorders since the mid-1990s, and trained thousands of healthcare providers in optimal treatment methods during a 5 year series of national one-day seminars.  Perhaps most importantly, Dr. Komor himself has been in recovery from very serious OCD since the mid-1990’s making him uniquely qualified to understand and assist others struggling with OCD!
 
GETTING STARTED
 
The first steps happen prior to the actual IOPHC.  In a structured telephone interviewwe first gather detailed diagnostic information to determine if the IOPHC is necessary and has a high likelihood of being helpful.  This involves a formal one-hour interview with (hopefully) both patient and family. 
 
Keeping in mind it is usually best to start with the least invasive intervention first and progress from there, it is noteworthy that, in the great majority of situations, an IOPHC is determined not to be necessary.  For most patients their circumstances and type of OCD will allow them to progress successfully via 5-7 day per week Intensive Outpatient Telephone Counseling (IOTC).  This  format allows the doctor to actually conduct Exposure and Response Prevention Behavior Therapy alongside the patient in the home – almost as if the counselor was there in the home with the patient!  A clinical office is the worst place to treat OCD.  The best location is where the OCD is actually happening.  Having a counselor physically in the home, work, or community setting with the patient is optimal, but often unaffordable and problematic in toher ways.  Since counseling is done using the spoken word the telephone affords a perfect solution.  This makes Intensive Outpatient treatment powerful and affordable.  This is especially true as we are normally able to taper off the frequency of meetings after a few weeks progressing towards a “maintenance level” of a few session per month or on an “as needed” basis.  The typical cost for residential OCSPEC treatment can be over $7,000 per week.  Daily IOTC costs only $700 per week for IOTC!
 
 
WORKING WITH THE OCD WHERE IT WORKS ON YOU
 
For those that do require a physical house-call, our aim in the IOPHC program is to assist in creating rapid change.  Our aim is to put the patient on an aggressive path back out of the wilderness of obsessions and compulsions and restore life serenity and optimal functioning as rapidly as possible.  Working in the home and local environment conducting behavior exercises and teaching the basics of living successfully with OCD is the ultimate intervention for those who have tried traditional counseling and medication strategies.
 
On any particular day of the IOPHC the visiting doctor may be meeting with the patient, conferencing with family, employers, friends and other treating professionals, conducting psychological testing, developing written handouts and aftercare materials, etc.  Not all time is spent in consultation with the patient.  Total patient contact time averages 6 hours per day.  The first several days of the OCD Intensive Outpatient will be spent on information gathering and problem formulation and the second half on presentation and discussion of the implementation of strategies for recovery. 
 
At the conclusion of the IOPHC detailed follow-up instructions for continuing the recovery process will be provided in the form of an Aftercare Plan.  Telephone and e-mail consultations are then scheduled as part of the follow-up programming. 
 
 
MANAGEABLE WORK PERIODS
 
Having and working on OCD is very anxiety provoking.  Most people with significant OCD cannot tolerate more than a few hours of ERP work.  During the housecall we almost always meet in 2-3 hour time blocks similar to this:
 
09:00am – 12:00am    SESSION
12:00pm – 02:00pm   HOMEWORK/BREAK*
02:00pm – 05:00pm   SESSION
05:00pm – 09:00am   HOMEWORK/BREAK*
 
* During breaks patients should be resting, relaxing their nervous system, doing homework exercises (if suggested).  (In terms of achieving optimal nervous system balance we recommend obtaining the easy-to-use “EM Wave” biofeedback device from www.heartmath.com and learning to use it prior to the IOPHC. Meanwhile, your doctor is organizing information gained during you time together and developing strategies and recommendations for the next session.
     
While, for most patients, it is not possible to complete a recovery process which eliminates all OCD symptoms in the time available during the average OCD Intensive Outpatient visit we do expect to: (1) Lay powerful and comprehensive groundwork for ongoing self-treatment and (2) Make significant initial headway so that the process of recovery is set in motion and need only be continued to achieve ultimate success and, (3) Develop an effective continuing-care plan inclusive of  loved ones, local mental health support and other caregivers.   The patient need only continue with the process which has been initiated during the IOPHC to achieve success and eventual recovery. 
 
PRACTICE – PRACTICE – PRACTICE!!
 
The OCD Recovery Centers of America HCIOP curriculum is tailored to the individual, but may look something like this during the first several days:
 
DAY 1: OCD 101 / Interviews and Data Collection (Family and Patient)
  • Information, Education and Understanding Including OC Cycles
  • Understanding Core Family of Origin Patterns Relative to Disorder
  • Addressing personal and family patterns which conflict with recovery (including reassurance)
  • Initiating or Refining Psychoactive and, or Phytomedicinal Medication Support
  • Developing Lifestyle Management and Self-Care Skills (Including HRVT, ATT, diet, exercise)
 
DAY 2: Overview of Strategy and Treatment (Patient)
  • The Nature of Life and Death
  • What fell into the OCD “quicksand”
  • Addressing OCD-onset trauma
  • Mapping the OCD
 
DAY 3: ERP Work / Recovery Buddy Training (Patient and Recovery Buddy)
  • Developing Exposure and Response Prevention (ERP) behavior therapy exercises to counter the OCD
  • Training the “Recovery Buddy”
  • Multisensory Massed Exposure
 
DAY 4: ERP Work (Patient and Recovery Buddy)
  • Healthy being and spontaneity
  • Short term goals
  • Long term goals
  • Developing Relapse Prevention Plan Including Emergency Plan and Ongoing Resource/Support Utilization



IS AN INTENSIVE OUTPATIENT HOUSECALL APPROPRIATE IN OUR SITUATION?
 
The IOPHC model is highly effective for children and adults who are diagnosed with, or believe they suffer from an obsessive compulsive spectrum disorder such as OCD, Hypochondriasis, Body Dysmorphic Disorder, Trichotillomania, Tourette’s Syndrome.  It is particularly helpful in more severe situations where the patient has difficulty leaving the home, or has been unable to utilize other programs or resources.  Note that IOPHC housecalls are not appropriate for persons with primary Schizophrenia, Bipolar Disorder, Borderline Personality Disorder, untreated substance abuse problems, Dissociative Identity Disorder, or primary Post-Traumatic Stress Disorder. 
 
Intensive Outpatient housecalls generally achieve outstanding results in terms of setting in place a concrete pathway for recovery from the OC disorder being targeted.  In considering the appropriateness of an IOPHC in a particular situation, it is helpful to keep in mind that the IOPHC is a significant investment of energy, time and financial resources.   The IOPHC is a significant and life-changing process and we advise giving the decision careful scrutiny.  During the IOP we will be exploring together in-depth many different aspects of the OCD in the home environment as well as in the school, community and workplace (as appropriate).  Mostly due to the expense of the IOPHC (see below) we often recommend that the prospective patient first consider our Teleconferencing Program.  If, after several telephone or video conferences, the patient’s condition is not improving the next step would be to proceed with the IOPHC.
 
 
COSTS ASSOCIATED WITH THE IOPHC PROGRAM
 
 *All fees are normally paid by Credit/Debit Card
 
  • Pre-IOPHC interview and case review fee = $160.
 
  • Advance Retainer (holds the time slot we have booked for you) = $1,200.  This retainer is refundable up to 14 days prior to the first day of the IOP-HC.
 
  • Professional time for each day of the IOPHC is $1,200 + $150 per diem expenses = $1,350.  (About what you would pay for a comparable number of hours just visiting your local psychologist in their office!) 
 
Notes: Each day of the IOPHC is considered separate allowing the patient freedom to decide to discontinue at any time or extend the planned number of days.  With this in mind we ask that professional fees and expenses for each day of the IOPHC be paid at the end of that day (starting with the second day – the first having been covered by the retainer).  Also, it is customary for Dr. Komor to arrive the day before the IOPHC to ensure a timely start to the treatment sessions.
 
  • Expenses to your location: 

Best available economy airfare. (This option is generally less expensive and we are able to get to your location sooner.
 
or:

Actual fuel and meal expenses between the current geographic location of the OCD IOP Bus and your location (we provide receipts). 
 
Notes:  All air travel arrangements are made directly by our office.  You may use frequent flyer miles to cover air travel.  Let us know if you wish to do so.  If traveling by air, once on-site there is an additional $200 per diem charge which covers hotel, food, car rental and any other expenses.  Thus the costs are $1,200 treatment fee + $200 per diem + Travel.  Medical Insurance will sometimes cover the direct service / professional fee aspects of the IOP Program, but never covers hotel, travel and other costs.  We will do everything possible to assist you in utilizing your insurance benefits.

QUESTIONS?
 
Our primary purpose is to assist those suffering with Obsessive Compulsive Disorders and help them regain their free will and life satisfaction from the grip of this disabling neuropsychiatric disability.  Please feel free to contact our office with any questions you might have.  By phone (888) 405-7627 or email dr.komor@gmail.com.  Also, more information about OCD and its treatment can be found on our web site at www.ocdrecoverycenters.com or upon request.
 
Once you have read through this information please contact Dr. Komor by email to confirm a starting date for the Intensive Outpatient Housecall. 
 
We Look Forward to Being of Assistance


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