ADULT

Save the Date!
OCF 15th Annual Conference
August 1-3, 2008

The Obsessive Compulsive Disorders Institute

A clinical collaboration between McLean Hospital
and Massachusetts General Hospital.

Michael Jenike, MD Medical Director
Diane Davey, RN, MBA Program Director
Jeff Szymanski, PhD Director of Psychological Services

The Massachusetts General Hospital/McLean Hospital OCD Institute at McLean Hospital serves as a national and regional center dedicated to the advancement of clinical care, teaching and research of obsessive compulsive disorders. The program provides partial hospital and intensive residential levels of care for individuals age 16 and older who suffer from severe or treatment-resistant OCD.

OCD occurs in two to five percent of the population, and is the fourth most common psychiatric diagnosis. The majority of OCD patients who have not experienced symptom relief may have not received adequate trials of appropriate and/or behavioral therapy. The remainder typically do not respond because of poor treatment compliance, unrecognized cognitive impairment, concomitant psychiatric illness or poor understanding of treatment. Adequate treatment for OCD often requires that medication trials be longer than those for other psychiatric illnesses, while behavioral interventions are time- and labor-intensive, frequently requiring close supervision and support.

The OCD Institute provides a comprehensive program that integrates somatic, behavioral and milieu treatments to serve treatment refractory OCD and its most common co-morbid conditions.

Milieu and Group Therapy

North Belknap

The milieu is constructed to stress close patient involvement in the treatment process—the patient is viewed as a colleague in his own treatment, rather than simply a passive recipient. Each patient, based on feedback from staff and other patients, completes a weekly therapeutic contract detailing his treatment plan for the upcoming week. At the end of the week, the patient receives feedback once again from staff and other patients on the progress and effort he has made. Patients complete regular objective measures of improvement, and attend five to six therapy groups per day. Group therapy targets increasing motivation and compliance, decreasing behavioral symptoms, increasing normalized family, work and social functioning, and providing education and support.

Psychopharmacology and Somatic Treatment

Michael Jenike, MD, the program's clinical director, oversees the treatment of all patients. He and the other program psychiatrists meet with patients weekly.

Behavior Therapy

Each patient is assigned a behavior therapist who meets with the patient individually several times each week. The behavior therapist is responsible for devising a behavioral program for each patient that serves as a guideline for staff to insure consistency. The behavioral program identifies target obsessions, compulsions and avoidance behaviors, provides a menu of exposures for staff to implement and recommends special instructions for each patient. In addition to individual meetings with the behavior therapist, the patient also engages in daily two-hour exposure and response-prevention exercises with the direct care staff, both individually and in groups.

Social Work

Each patient is assigned to one of the program's independently licensed social workers, who meets with the patient at least weekly to provide case management, develop a treatment plan and lead team meetings to discuss case formulation. In addition, the social worker also provides family therapy as needed and works with the patient around discharge planning.

Nursing and Counseling Staff

Members of the program's nursing and counseling staff provide day-to-day patient treatment. These individuals are responsible for the overall milieu management and work with patients both individually and in groups to meet the expectations of their treatment contracts and behavioral therapy. All counselors have specific training for working with OCD patients and behavior therapy techniques, as well as general crisis prevention/intervention, CPR and group leadership skills.

Continuum of Care

The program's clinical staff evaluates all patients for admission to the program. While many will require the most intensive residential level of care due to the severity of their symptoms, many may be able to use the program only during the day while residing elsewhere. The goal is to move patients to less acute levels of care as soon as they are able.

Helpful Links

Information and Referral

McLean accepts Medicare, Massachusetts Medicaid, Blue Cross and many other private health insurance plans. The hospital also has working arrangements with many managed care companies. Insurance coverage may be limited for some services, especially for longer-term residential treatment. Please call Diane Davey, RN, MBA, at 617.855.3279 or email her at davey@ocd.mclean.org.